Provider Demographics
NPI:1093212482
Name:MCGHEE, KENDRA HOLLEY (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:HOLLEY
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 MARLEE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6108
Mailing Address - Country:US
Mailing Address - Phone:252-544-1989
Mailing Address - Fax:
Practice Address - Street 1:2109 SAINT ANDREW ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-2149
Practice Address - Country:US
Practice Address - Phone:252-544-1989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0122491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical