Provider Demographics
NPI:1508134198
Name:BRUNET, KENDYL TIPTON (MSW, LCSW-BACS)
Entity Type:Individual
Prefix:MRS
First Name:KENDYL
Middle Name:TIPTON
Last Name:BRUNET
Suffix:
Gender:F
Credentials:MSW, LCSW-BACS
Other - Prefix:MISS
Other - First Name:KENDYL
Other - Middle Name:LEIGH
Other - Last Name:TIPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LMSW
Mailing Address - Street 1:2626 CANAL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6410
Mailing Address - Country:US
Mailing Address - Phone:504-525-2366
Mailing Address - Fax:504-525-7525
Practice Address - Street 1:2626 CANAL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6410
Practice Address - Country:US
Practice Address - Phone:504-525-2366
Practice Address - Fax:504-525-7525
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical