Individual provider Active NPI

Michaelangelo McClendon, LMHCA

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1275862534
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
99123093A Issued in IN
Practice address
4095 Point Bar Rd Apt 1C
Indianapolis, IN 46268-3774
Phone
(240) 353-9275
Fax
(317) 222-4294
NPI assigned
Dec 16, 2009
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 99123093A IN Primary

Addresses

Primary practice location

4095 Point Bar Rd Apt 1C
Indianapolis, IN 46268-3774

Mailing address

4095 Point Bar Rd Apt 1C
Indianapolis, IN 46268-3774
Phone (240) 353-9275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99123093AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
M & M Consulting LLC Mental Health CurrentSince Mar 17, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1275862534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4095 POINT BAR RD APT 1C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683774",
            "telephone_number": "240-353-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 POINT BAR RD APT 1C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683774",
            "telephone_number": "240-353-9275",
            "fax_number": "317-222-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "MICHAELANGELO",
        "name_prefix": "Mr.",
        "credential": "LMHCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-16",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "99123093A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.