Provider Demographics
NPI:1821578469
Name:KANDRA, LINDSAY (LPC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:KANDRA
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 1:320 SW CENTURY DRIVE, SUITE 405 #173
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702
Mailing Address - Country:US
Mailing Address - Phone:503-308-3064
Mailing Address - Fax:
Practice Address - Street 1:18575 SW CENTURY DR UNIT 1711
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1950
Practice Address - Country:US
Practice Address - Phone:503-308-3064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR5401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health