Provider Demographics
NPI:1336561281
Name:JOHNSON-MCCLENDON, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:JOHNSON-MCCLENDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45964 BRENTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-5410
Mailing Address - Country:US
Mailing Address - Phone:248-658-1116
Mailing Address - Fax:248-658-1120
Practice Address - Street 1:45964 BRENTWOOD ST
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-5410
Practice Address - Country:US
Practice Address - Phone:248-658-1116
Practice Address - Fax:248-658-1120
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health