Individual provider Active NPI

Jean A. McLendon, LCSW LMFT

  • Clinical Social Worker
  • Chapel Hill, NC
National Provider Identifier
1174626378
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000736 Issued in NC
Practice address
109 Conner Dr
BLDG 3, Ste 107
Chapel Hill, NC 27514-7039
Phone
(919) 967-2520
Fax
(919) 967-0515
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 000736 NC Primary
Marriage & Family Therapist 106H00000X 118 NC

Addresses

Primary practice location

109 Conner Dr
BLDG 3, Ste 107
Chapel Hill, NC 27514-7039

Mailing address

109 Conner Dr
BLDG 3, Ste 107
Chapel Hill, NC 27514-7039
Phone (919) 967-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2013 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000736NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1174626378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CONNER DR",
            "address_2": "BLDG 3, STE 107",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275147039",
            "telephone_number": "919-967-2520",
            "fax_number": "919-967-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CONNER DR",
            "address_2": "BLDG 3, STE 107",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275147039",
            "telephone_number": "919-967-2520",
            "fax_number": "919-967-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENDON",
        "first_name": "JEAN",
        "middle_name": "A.",
        "credential": "LCSW LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "000736",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.