Provider Demographics
NPI:1508221276
Name:HUMES, KENDAL WELLINGTON (LPC, LAC, LIAC)
Entity type:Individual
Prefix:DR
First Name:KENDAL
Middle Name:WELLINGTON
Last Name:HUMES
Suffix:
Gender:
Credentials:LPC, LAC, LIAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 1/2 S UNION AVE UNIT 210
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3557
Mailing Address - Country:US
Mailing Address - Phone:719-582-4362
Mailing Address - Fax:
Practice Address - Street 1:1907 MOHAWK RD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1519
Practice Address - Country:US
Practice Address - Phone:719-582-4362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPC.0014468101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health