Provider Demographics
NPI:1740577337
Name:MACARTHUR, KENDALL (MA)
Entity type:Individual
Prefix:MRS
First Name:KENDALL
Middle Name:
Last Name:MACARTHUR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:FRIDLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-0279
Mailing Address - Country:US
Mailing Address - Phone:517-550-5423
Mailing Address - Fax:517-245-1911
Practice Address - Street 1:176 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-0279
Practice Address - Country:US
Practice Address - Phone:517-550-5423
Practice Address - Fax:517-245-1911
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011761103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical