Provider Demographics
NPI:1174626378
Name:MCLENDON, JEAN A (LCSW LMFT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:A
Last Name:MCLENDON
Suffix:
Gender:F
Credentials:LCSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CONNER DR
Mailing Address - Street 2:BLDG 3, STE 107
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7039
Mailing Address - Country:US
Mailing Address - Phone:919-967-2520
Mailing Address - Fax:919-967-0515
Practice Address - Street 1:109 CONNER DR
Practice Address - Street 2:BLDG 3, STE 107
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7039
Practice Address - Country:US
Practice Address - Phone:919-967-2520
Practice Address - Fax:919-967-0515
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0007361041C0700X
NC118106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist