Provider Demographics
NPI:1710633722
Name:TOODLE-REGISTER, KENDRA LAKELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:LAKELLE
Last Name:TOODLE-REGISTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 KENT DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-2258
Mailing Address - Country:US
Mailing Address - Phone:860-810-8510
Mailing Address - Fax:
Practice Address - Street 1:153 KENT DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-2258
Practice Address - Country:US
Practice Address - Phone:860-810-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT119891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical