Provider Demographics
NPI:1225409816
Name:CAMPBELL, KENDALL (LMFT-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13706 RESEARCH BLVD
Mailing Address - Street 2:STE 114
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1882
Mailing Address - Country:US
Mailing Address - Phone:512-920-3654
Mailing Address - Fax:
Practice Address - Street 1:13706 RESEARCH BLVD
Practice Address - Street 2:STE 114
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1882
Practice Address - Country:US
Practice Address - Phone:512-920-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202563106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist