Provider Demographics
NPI:1780977561
Name:MCCLURE, NATHAN (LSW, MSW, LCSWI)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:LSW, MSW, LCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 YOUTH CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:CALIENTE
Mailing Address - State:NV
Mailing Address - Zip Code:89008
Mailing Address - Country:US
Mailing Address - Phone:775-726-8214
Mailing Address - Fax:
Practice Address - Street 1:500 YOUTH CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:CALIENTE
Practice Address - State:NV
Practice Address - Zip Code:89008
Practice Address - Country:US
Practice Address - Phone:775-726-8214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5192-S1041C0700X
UT348443-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical