Provider Demographics
NPI:1619494630
Name:HEMMINGER, KENDRA NICOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:NICOLE
Last Name:HEMMINGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:KENDRA
Other - Middle Name:NICOLE
Other - Last Name:GORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KENDRA GORMAN
Mailing Address - Street 1:612 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2153
Mailing Address - Country:US
Mailing Address - Phone:937-474-3380
Mailing Address - Fax:
Practice Address - Street 1:651 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1965
Practice Address - Country:US
Practice Address - Phone:937-324-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700633101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor