Doctor Name: | COLLIN O. MCCLOY |
NPI Number: | 1093070740 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 455 |
Business Practice Address: | 501 S Burma Ave Gillette, WY - 827163426 |
Business Phone Number: | 3076885000 |
Business Fax Number: | 3076885015 |
Mailing Address: | 501 S Burma Ave, GILLETTE |
State: | WY |
Postal Code: | 827163426 |
Phone Number: | 3076885000 |
Fax Number: | 3076885015 |
NPI Enumeration Date: | 07/09/2012 |
NPI Last Update Date: | 08/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 455 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |