Provider Demographics
NPI:1457104994
Name:SAMPSON, KENDRA LYNN (MS, NCC)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:LYNN
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414-8005
Mailing Address - Country:US
Mailing Address - Phone:570-955-7778
Mailing Address - Fax:
Practice Address - Street 1:201 LACKAWANNA AVE UNIT 316
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1953
Practice Address - Country:US
Practice Address - Phone:570-766-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health