Provider Demographics
NPI:1346364551
Name:KARA M. HENDRY,PSY.D., P.A.
Entity Type:Organization
Organization Name:KARA M. HENDRY,PSY.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:MATILE
Authorized Official - Last Name:HENDRY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, PA
Authorized Official - Phone:727-322-6123
Mailing Address - Street 1:PO BOX 47918
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33743-7918
Mailing Address - Country:US
Mailing Address - Phone:727-322-6123
Mailing Address - Fax:727-322-6143
Practice Address - Street 1:5348 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8106
Practice Address - Country:US
Practice Address - Phone:727-322-6123
Practice Address - Fax:727-322-6143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6690103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1306947809OtherORIGINAL NPI #