Provider Demographics
NPI:1811553290
Name:ADAMS, KENDIA (LPC)
Entity Type:Individual
Prefix:
First Name:KENDIA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 ROSEWOOD MILL CT
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5107
Mailing Address - Country:US
Mailing Address - Phone:678-754-8828
Mailing Address - Fax:
Practice Address - Street 1:867 COMMERCE DR SW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6604
Practice Address - Country:US
Practice Address - Phone:770-679-4043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-12
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008844101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health