Provider Demographics
NPI:1649421355
Name:WILLIAMS, KENDRA A (LCSW, GC-C)
Entity Type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW, GC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 GRAMMAR ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-6100
Mailing Address - Country:US
Mailing Address - Phone:207-324-1947
Mailing Address - Fax:
Practice Address - Street 1:172 GRAMMAR ST.
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-6100
Practice Address - Country:US
Practice Address - Phone:207-324-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC45861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical