Provider Demographics
NPI:1215373253
Name:HILL, KENDRA J (MSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:J
Last Name:HILL
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3162 STOUENBURGH DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8699
Mailing Address - Country:US
Mailing Address - Phone:614-383-8252
Mailing Address - Fax:
Practice Address - Street 1:1373 GRANDVIEW AVE STE 212
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2804
Practice Address - Country:US
Practice Address - Phone:614-383-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1302426-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2615030Medicaid