Provider Demographics
NPI:1811036122
Name:MCLENDON, BETTY C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:C
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 1:623 RARITAN ROAD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066
Mailing Address - Country:US
Mailing Address - Phone:732-499-0505
Mailing Address - Fax:908-486-9117
Practice Address - Street 1:623 RARITAN ROAD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066
Practice Address - Country:US
Practice Address - Phone:732-499-0505
Practice Address - Fax:908-486-9117
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ355100251300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist