Provider Demographics
NPI:1225612872
Name:KENDRICK COUNSELING, PLLC
Entity Type:Organization
Organization Name:KENDRICK COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SENIOR THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:217-841-9674
Mailing Address - Street 1:2513 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-4737
Mailing Address - Country:US
Mailing Address - Phone:217-841-9674
Mailing Address - Fax:
Practice Address - Street 1:2513 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-4737
Practice Address - Country:US
Practice Address - Phone:217-841-9674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty