Provider Demographics
NPI:1225102486
Name:CLENDENING, KATHERINE G (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:G
Last Name:CLENDENING
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17585 NASSAU COMMONS BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6286
Mailing Address - Country:US
Mailing Address - Phone:302-245-8223
Mailing Address - Fax:
Practice Address - Street 1:500 W 10TH STREET
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801
Practice Address - Country:US
Practice Address - Phone:302-230-9154
Practice Address - Fax:302-691-1100
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100004971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000021594Medicaid
DE1689733792Medicaid
DE1000021594Medicaid