Provider Demographics
NPI:1558573014
Name:STEWART, KENDRA ALAIN (LPC)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:ALAIN
Last Name:STEWART
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 1:4333 FOREST PARK AVE
Mailing Address - Street 2:#1W
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2850
Mailing Address - Country:US
Mailing Address - Phone:314-721-4673
Mailing Address - Fax:314-721-8850
Practice Address - Street 1:7247 OLIVE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-2322
Practice Address - Country:US
Practice Address - Phone:314-721-4673
Practice Address - Fax:314-721-8850
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005026313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health