Provider Demographics
NPI:1376553321
Name:MARGOLIES, KENDELL HARDY (LCSW)
Entity Type:Individual
Prefix:
First Name:KENDELL
Middle Name:HARDY
Last Name:MARGOLIES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KENDELL
Other - Middle Name:
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1311 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2905
Mailing Address - Country:US
Mailing Address - Phone:518-374-6263
Mailing Address - Fax:
Practice Address - Street 1:1311 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2905
Practice Address - Country:US
Practice Address - Phone:518-374-6263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048047104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03886035Medicaid
NY03886035Medicaid