Healthcare Provider Details

I. General information

NPI: 1578927802
Provider Name (Legal Business Name): MCCLENDON RECOVERY INITIATIVES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 HOES LN STE 200
PISCATAWAY NJ
08854-4143
US

IV. Provider business mailing address

PO BOX 543
PISCATAWAY NJ
08855-0543
US

V. Phone/Fax

Practice location:
  • Phone: 732-903-2175
  • Fax:
Mailing address:
  • Phone: 888-376-7082
  • Fax: 855-240-7470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. JENNIFER MCCLENDON
Title or Position: PRESIDENT
Credential: LPC, LCADC
Phone: 888-376-7082