Provider Demographics
NPI:1558130435
Name:KENDALL, AMANDA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:KENDALL
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4101
Mailing Address - Country:US
Mailing Address - Phone:828-301-4622
Mailing Address - Fax:828-513-5004
Practice Address - Street 1:709 5TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4101
Practice Address - Country:US
Practice Address - Phone:828-301-4622
Practice Address - Fax:828-513-5004
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health