MEDICARE: ALEXIS BRIANNA 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
1	1041C0700X	Clinical Social Worker	13249-C	NV

General Provider Information

NPI Number	:	1477320224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS BRIANNA MCCLENDON

Provider Business Mailing Address
First Line	:	1650 E SAHARA AVE STE 4A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3495
Country	:	US
Telephone Number	:	702-769-0584
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 E SAHARA AVE STE 4A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3495
Country	:	US
Telephone Number	:	702-769-0584
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	06/19/2026

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