Provider Demographics
NPI:1114568797
Name:CANADY, KENDRA SHARI (LAMFT)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:SHARI
Last Name:CANADY
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:CRUDUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13421 N 43RD AVE APT 3100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-1042
Mailing Address - Country:US
Mailing Address - Phone:480-519-6740
Mailing Address - Fax:
Practice Address - Street 1:4425 W OLIVE AVE STE 151
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-3855
Practice Address - Country:US
Practice Address - Phone:602-456-4817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-10654106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist