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NPI Code Detail

MEDICARE: MELVIN MCCLENDON

MEDICARE:   MELVIN  MCCLENDON
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
1101YM0800XMental Health Counselor
2225400000XRehabilitation Practitioner
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1144526146
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELVIN MCCLENDON
Provider Business Mailing Address
First Line : 3455 W CRAIG RD STE C
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89032-5119
Country : US
Telephone Number : 702-982-0600
Fax Number :
Provider Business Practice Location Address
First Line : 1700 E DESERT INN RD STE 103
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3206
Country : US
Telephone Number : 702-862-4774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2011
Last Update Date : 05/01/2020

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Directions to “ MELVIN MCCLENDON ” Practice Location

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