Individual
ADAM BLAKE MCCLOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
609 HAMILTON ST, JOHNSON CITY, TN 37604-5403
(423) 863-0280
Mailing address
1362 OLD SNAPPS FERRY RD, CHUCKEY, TN 37641-4241
(423) 863-0280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4653
TN
Other
Enumeration date
09/23/2019
Last updated
08/27/2020
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