Active NPI
Robert McClellan, LAC
- Professional Counselor
- Gilbert, AZ
National Provider Identifier
1396372371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LAC-17605
- Practice address
- 3336 E Chandler Heights Rd Ste 123
Gilbert, AZ 85298-4263 - Phone
- (480) 581-1273
- NPI assigned
- Mar 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LAC-17605 | AZ | Primary |
Addresses
Primary practice location
3336 E Chandler Heights Rd Ste 123
Gilbert, AZ 85298-4263
Mailing address
2670 E Stacey Rd
Gilbert, AZ 85298-0113
Phone (623) 688-6892
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-17605 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585267200000",
"number": "1396372371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2670 E STACEY RD",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852980113",
"telephone_number": "623-688-6892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3336 E CHANDLER HEIGHTS RD STE 123",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852984263",
"telephone_number": "480-581-1273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAN",
"first_name": "ROBERT",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-27",
"last_updated": "2020-03-27",
"certification_date": "2020-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LAC-17605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.