Individual
MS. IRENE ANN MCCLUSKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001127A
IN
1041C0700X
Clinical Social Worker
Primary
34006076A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300046512
—
IN
Enumeration date
10/07/2010
Last updated
06/04/2024
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