Provider Demographics
NPI:1811552987
Name:MCCLENDON, LEVI (PHD, LPC-S, RPT)
Entity type:Individual
Prefix:DR
First Name:LEVI
Middle Name:
Last Name:MCCLENDON
Suffix:
Gender:
Credentials:PHD, LPC-S, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-3828
Mailing Address - Country:US
Mailing Address - Phone:936-874-8173
Mailing Address - Fax:936-244-4501
Practice Address - Street 1:520 S 1ST ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-3828
Practice Address - Country:US
Practice Address - Phone:936-874-8173
Practice Address - Fax:936-244-4501
Is Sole Proprietor?:No
Enumeration Date:2019-05-04
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72662101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health