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NPI Code Detail

MEDICARE: MRS. ELIZABETH A MCCLENDON LCSW

MEDICARE: MRS. ELIZABETH A MCCLENDON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerNJ

General Provider Information

NPI Number : 1013194240
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH A MCCLENDON LCSW
Provider Business Mailing Address
First Line : 427 HORY ST
Second Line :
City : ROSELLE
State : NJ
Zip : 07203-2337
Country : US
Telephone Number : 908-259-9192
Fax Number : 973-266-7950
Provider Business Practice Location Address
First Line : 37 EVERGREEN PL
Second Line :
City : EAST ORANGE
State : NJ
Zip : 07018-2154
Country : US
Telephone Number : 973-266-7992
Fax Number : 973-266-7950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2008
Last Update Date : 01/30/2008

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