MS. CYNTHIA ELAINE MCCLURG MED LPC, NPI 1508855453 — BULLHEAD CITY (AZ)

NPI 1508855453

14+ Years Experience Individual

MS. CYNTHIA ELAINE MCCLURG MED LPC

10/13/2005
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1508855453
NPI NUMBER

About MS. CYNTHIA ELAINE MCCLURG

MS. CYNTHIA ELAINE MCCLURG is a provider established in BULLHEAD CITY, AZ. The NPI number of MS. CYNTHIA ELAINE MCCLURG is 1508855453 and was assigned on 10/13/2005. The practitioners primary taxonomy code is: 101Y00000X with license number: LPC10657 AZ .

Mailing address

  • City: KINGMAN
  • State: AZ
  • Postal code: 864090927
  • Phone: 9287578111
  • Fax: 9287573256
  • Address: 1743 SYCAMORE AVE
  • Address 2: MOHAVE MENTAL HEATLH CLINIC INC

Primary Practice Address

  • Region : BULLHEAD CITY, AZ
  • NPI : 1508855453
  • Phone : 9287585905
  • Fax : 9287573256
  • Postalcode : 864425716
  • Address : 1145 MARINA BLVD

Provider taxonomy - Counselor

  • Taxonomy code: 101Y00000X
  • License number: LPC10657
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master"s degree and clinical experience and supervision for licensure or certification.

Contacts:

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  • MS. CYNTHIA ELAINE MCCLURG MED LPC
  • Address : 1145 MARINA BLVD
  • Region : BULLHEAD CITY, AZ
  • NPI : 1508855453
  • Phone : 9287585905
  • Fax : 9287573256
  • Postalcode : 864425716

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1145 MARINA BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameBULLHEAD CITY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code864425716
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number9287585905
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number9287573256
The fax number associated with the location address of the provider being identified.
NPI1508855453
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1101Y00000X
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master"s degree and clinical experience and supervision for licensure or certification.
Provider Enumeration Date10/13/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MS. CYNTHIA ELAINE MCCLURG
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1743 SYCAMORE AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressMOHAVE MENTAL HEATLH CLINIC INC
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameKINGMAN
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code864090927
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number9287578111
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number9287573256
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1101Y00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Counselor
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master"s degree and clinical experience and supervision for licensure or certification.
Provider License Number 1LPC10657
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1AZ
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorX
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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