Provider Demographics
NPI:1821430034
Name:KENDRICK, BRENDA RICHARDSON (LCSWA, MSW)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:RICHARDSON
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:LCSWA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SCALEYBARK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2687
Mailing Address - Country:US
Mailing Address - Phone:704-567-8690
Mailing Address - Fax:
Practice Address - Street 1:145 SCALEYBARK RD
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2687
Practice Address - Country:US
Practice Address - Phone:704-567-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0077921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical