Provider Demographics
NPI:1144388927
Name:KENDRICK, DAPHNE R (LCSW)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:R
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DAPHNE
Other - Middle Name:R
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 689
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-0689
Mailing Address - Country:US
Mailing Address - Phone:205-668-4308
Mailing Address - Fax:205-668-0894
Practice Address - Street 1:2100 COUNTY SERVICES DR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-6150
Practice Address - Country:US
Practice Address - Phone:205-663-1252
Practice Address - Fax:205-663-3175
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1406C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALJ149Medicare PIN