Provider Demographics
NPI:1841285285
Name:MCLENDON, JOYCE ANN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:MCLENDON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 S COBB DR SE
Mailing Address - Street 2:STE. H #180
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6990
Mailing Address - Country:US
Mailing Address - Phone:404-601-2894
Mailing Address - Fax:404-601-2896
Practice Address - Street 1:3475 LENOX RD NE
Practice Address - Street 2:SUITE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-3227
Practice Address - Country:US
Practice Address - Phone:404-601-2894
Practice Address - Fax:404-601-2896
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0033401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA250881558BMedicaid
GA250881558AMedicaid
GA250881558BMedicaid
GAQ45134Medicare UPIN