Provider Demographics
NPI:1669827945
Name:BASSARD, KENDALL (LMHC, LCPC)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:BASSARD
Suffix:
Gender:F
Credentials:LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8935 EARLY APRIL WAY APT K
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2439
Mailing Address - Country:US
Mailing Address - Phone:240-274-1474
Mailing Address - Fax:
Practice Address - Street 1:90 PAINTERS MILL RD STE 203
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3614
Practice Address - Country:US
Practice Address - Phone:410-413-4108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12201101YM0800X
NY009331101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health