Provider Demographics
NPI:1679638472
Name:KENDRICK, TEENA YONNE (LICENSED MENTAL)
Entity Type:Individual
Prefix:MS
First Name:TEENA
Middle Name:YONNE
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:LICENSED MENTAL
Other - Prefix:MS
Other - First Name:TEENA
Other - Middle Name:YONNE
Other - Last Name:FREELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3995 MARCOLA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-7948
Mailing Address - Country:US
Mailing Address - Phone:541-726-1465
Mailing Address - Fax:541-726-5085
Practice Address - Street 1:3995 MARCOLA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-7948
Practice Address - Country:US
Practice Address - Phone:541-726-1465
Practice Address - Fax:541-726-5085
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1587101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
240376OtherMIDLANDS CHOICE
NE84014OtherBCBS