Provider Demographics
NPI:1073204111
Name:HENDLEY, KATHRYN (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HENDLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:KELKENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3470 MCCLURE BRIDGE RD UNIT 2511
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1125
Mailing Address - Country:US
Mailing Address - Phone:678-551-0586
Mailing Address - Fax:
Practice Address - Street 1:2810 PEACHTREE INDUSTRIAL BLVD STE D
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8142
Practice Address - Country:US
Practice Address - Phone:404-919-6722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW009720104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker