Provider Demographics
NPI:1740754639
Name:MCCLENDON, SHARLENE HILTON (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHARLENE
Middle Name:HILTON
Last Name:MCCLENDON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 HABERSHAM RDG SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5603
Mailing Address - Country:US
Mailing Address - Phone:770-597-7612
Mailing Address - Fax:
Practice Address - Street 1:4716 HABERSHAM RDG SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-5603
Practice Address - Country:US
Practice Address - Phone:770-597-7612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health