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NPI Code Detail

MEDICARE: DR. LEVI MCCLENDON PHD, LPC-S, RPT

MEDICARE: DR. LEVI MCCLENDON PHD, LPC-S, RPT
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
1101YP2500XProfessional Counselor72662TX

General Provider Information

NPI Number : 1811552987
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEVI MCCLENDON PHD, LPC-S, RPT
Provider Business Mailing Address
First Line : 520 S 1ST ST
Second Line :
City : LUFKIN
State : TX
Zip : 75901-3828
Country : US
Telephone Number : 936-874-8173
Fax Number : 936-244-4501
Provider Business Practice Location Address
First Line : 520 S 1ST ST
Second Line :
City : LUFKIN
State : TX
Zip : 75901-3828
Country : US
Telephone Number : 936-874-8173
Fax Number : 936-244-4501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2019
Last Update Date : 07/07/2025

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