Provider Demographics
NPI:1851448856
Name:KENDRICK, JAMES H (MALMSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:KENDRICK
Suffix:
Gender:M
Credentials:MALMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 HERBERT RD
Mailing Address - Street 2:
Mailing Address - City:DELTON
Mailing Address - State:MI
Mailing Address - Zip Code:49046-9422
Mailing Address - Country:US
Mailing Address - Phone:269-377-3819
Mailing Address - Fax:
Practice Address - Street 1:112 E CHART ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1768
Practice Address - Country:US
Practice Address - Phone:269-685-6363
Practice Address - Fax:269-685-5995
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801033248101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health