Provider Demographics
NPI:1467103465
Name:ANDERSON, NAJUKA KENDRA (LPC)
Entity Type:Individual
Prefix:
First Name:NAJUKA
Middle Name:KENDRA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8212 ITHACA AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2638
Mailing Address - Country:US
Mailing Address - Phone:806-239-3735
Mailing Address - Fax:
Practice Address - Street 1:8212 ITHACA AVE STE 3
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2638
Practice Address - Country:US
Practice Address - Phone:806-239-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77629101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX77629OtherLPC LICENSE