Individual
CAROL CLENDINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, CAP, RN
Contact information
Practice address
115 E CITRUS AVE, EUSTIS, FL 32726-4107
(352) 357-1500
(352) 360-6582
Mailing address
35618 CALLA CT, LEESBURG, FL 34788-2306
(352) 357-1500
(352) 360-6582
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
CAP 311
FL
103TC0700X
Clinical Psychologist
MH 2625
FL
163W00000X
Registered Nurse
RN 793372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z090Q
BLUE CROSS BLUE SHIELD #
FL
Enumeration date
04/14/2006
Last updated
09/11/2025
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