Provider Demographics
NPI:1770079972
Name:WRIGHT-BAKER, KENDRA R (LCSW)
Entity type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:R
Last Name:WRIGHT-BAKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 PROSPECT AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-2543
Mailing Address - Country:US
Mailing Address - Phone:616-466-3270
Mailing Address - Fax:
Practice Address - Street 1:1915 PROSPECT AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-2543
Practice Address - Country:US
Practice Address - Phone:616-466-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical