Healthcare Provider Details

I. General information

NPI: 1831630672
Provider Name (Legal Business Name): JENNIFER CLENDENING MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2387 OLD SALEM RD
AUBURN HILLS MI
48326-3431
US

IV. Provider business mailing address

2387 OLD SALEM RD
AUBURN HILLS MI
48326-3431
US

V. Phone/Fax

Practice location:
  • Phone: 248-229-3118
  • Fax:
Mailing address:
  • Phone: 248-229-3118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401015952
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: