Provider Demographics
NPI:1003873985
Name:KENDRICK, CAROL (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-1302
Mailing Address - Country:US
Mailing Address - Phone:479-751-5577
Mailing Address - Fax:479-756-2526
Practice Address - Street 1:501 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-1302
Practice Address - Country:US
Practice Address - Phone:479-751-5577
Practice Address - Fax:479-756-2526
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARM9804022106H00000X
AR9301002101YP2500X
AR78-13E103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool