Provider Demographics
NPI:1366640708
Name:BAILEY, KENDRA J (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5925 COUNCIL ST NE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5878
Mailing Address - Country:US
Mailing Address - Phone:319-393-6796
Mailing Address - Fax:319-378-8621
Practice Address - Street 1:5925 COUNCIL ST NE
Practice Address - Street 2:SUITE 120
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5878
Practice Address - Country:US
Practice Address - Phone:319-393-6796
Practice Address - Fax:319-378-8621
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health