Provider Demographics
NPI:1477083228
Name:SPIELMAN, KENDRA (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:SPIELMAN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 1ST ST N APT 134
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-3323
Mailing Address - Country:US
Mailing Address - Phone:971-220-2127
Mailing Address - Fax:844-605-1865
Practice Address - Street 1:360 1ST ST N APT 134
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-3323
Practice Address - Country:US
Practice Address - Phone:971-220-2127
Practice Address - Fax:844-605-1865
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23443104100000X, 1041C0700X
ORL95171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker