Individual
CARLY ALYSE MCCLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6200 LAKESIDE AVE, HENRICO, VA 23228-5248
(804) 307-2801
Mailing address
6200 LAKESIDE AVE, HENRICO, VA 23228-5248
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701011785
VA
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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