Organization
KIMBERLY B. MCCLELLAND, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SIZEMORE (OFFICE MANAGER)
(318) 861-1090
Entity
Organization
Contact information
Practice address
820 JORDAN ST. STE 510W, SHREVEPORT, LA 71101
(318) 861-1090
(318) 606-2038
Mailing address
820 JORDAN ST STE 510W, SHREVEPORT, LA 71101-4526
(318) 861-1090
(318) 606-2038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2189
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2189
LICENSE
LA
Enumeration date
05/18/2018
Last updated
05/18/2018
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