Provider Demographics
NPI:1053918417
Name:MCCLAIN, TRACEY MARIA (LCSW-S)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:MARIA
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 WATERLOO DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-5406
Mailing Address - Country:US
Mailing Address - Phone:214-707-3537
Mailing Address - Fax:
Practice Address - Street 1:596 WATERLOO DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-5406
Practice Address - Country:US
Practice Address - Phone:121-470-7353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical