Provider Demographics
NPI:1003494675
Name:KENDALL, EMILY ANN (LCPAT, LCPC)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:ANN
Last Name:KENDALL
Suffix:
Gender:F
Credentials:LCPAT, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 SAMS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:MD
Mailing Address - Zip Code:21776-8315
Mailing Address - Country:US
Mailing Address - Phone:240-394-0085
Mailing Address - Fax:
Practice Address - Street 1:439 KLEE MILL RD APT D
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9620
Practice Address - Country:US
Practice Address - Phone:240-394-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDATC343221700000X
MDLC15257101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist