Individual
MICHAEL W CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC, LCADC
Contact information
Practice address
10630 LITTLE PATUXENT PKWY, SUITE 209, COLUMBIA, MD 21044-3273
(410) 740-8066
(410) 740-8068
Mailing address
10630 LITTLE PATUXENT PKWY, SUITE 209, COLUMBIA, MD 21044-3264
(410) 740-8066
(410) 740-8068
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA323
MD
101YM0800X
Mental Health Counselor
Primary
LC1210
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
647213-01
CAREFIRST RENDERING
MD
01
—
M3280007
BC/BS NATL CAP REGION
MD
Enumeration date
06/23/2006
Last updated
06/17/2014
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