Provider Demographics
NPI:1033790373
Name:KENDAL, LAURA (LCPC, CAC-AD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:KENDAL
Suffix:
Gender:F
Credentials:LCPC, CAC-AD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1309 BENJAMIN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5389
Mailing Address - Country:US
Mailing Address - Phone:410-812-2597
Mailing Address - Fax:
Practice Address - Street 1:608 BOSLEY AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4029
Practice Address - Country:US
Practice Address - Phone:410-812-2597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12303101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor