Provider Demographics
NPI:1033995949
Name:MCLENDON, ANGELICA (PSYD)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:MCLENDON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MARINERS WAY
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-3060
Mailing Address - Country:US
Mailing Address - Phone:704-244-6683
Mailing Address - Fax:
Practice Address - Street 1:7610 PENNSYLVANIA AVE STE 203
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-4716
Practice Address - Country:US
Practice Address - Phone:301-420-1972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0539103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical