Provider Demographics
NPI:1225363096
Name:SHERWOOD, KENDRA L (PHD)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:L
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11705 AIRPORT WAY STE 304
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-2711
Mailing Address - Country:US
Mailing Address - Phone:720-633-9693
Mailing Address - Fax:720-386-1086
Practice Address - Street 1:1191 S PARKER RD STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2153
Practice Address - Country:US
Practice Address - Phone:720-633-9693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4272103TC0700X
103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical