Provider Demographics
NPI:1740761477
Name:CAPLE, KENDRA S (MS, NCC)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:S
Last Name:CAPLE
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 N LUNA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-1234
Mailing Address - Country:US
Mailing Address - Phone:312-259-4156
Mailing Address - Fax:
Practice Address - Street 1:4471 LAWN AVE STE 202
Practice Address - Street 2:
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1765
Practice Address - Country:US
Practice Address - Phone:708-416-6562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
IL178014240101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional