Provider Demographics
NPI:1760375893
Name:MCCLURE, KATHRYN MAE (MED, LPC-A, NCC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MAE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:MED, LPC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MANLY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3023
Mailing Address - Country:US
Mailing Address - Phone:678-548-0324
Mailing Address - Fax:
Practice Address - Street 1:14 MANLY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3023
Practice Address - Country:US
Practice Address - Phone:864-729-3032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health