Individual
ANGELA C MCCLENDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, BCD, CCTP
Contact information
Practice address
39990 FAURE RD, HEMET, CA 92544-9408
(951) 708-4019
Mailing address
PO BOX 2748, HEMET, CA 92546-2748
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004788
GA
1041S0200X
School Social Worker
CSW004788
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134579A
—
GA
Enumeration date
06/04/2013
Last updated
12/30/2020
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