Provider Demographics
NPI:1528731833
Name:MCCLENDON, DUANNA CYNTHIA (LMSW)
Entity type:Individual
Prefix:
First Name:DUANNA
Middle Name:CYNTHIA
Last Name:MCCLENDON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 BOONE AVE APT 6C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-5782
Mailing Address - Country:US
Mailing Address - Phone:646-925-4338
Mailing Address - Fax:
Practice Address - Street 1:1544 BOONE AVE APT 6C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5782
Practice Address - Country:US
Practice Address - Phone:646-925-4338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113014-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker