Provider Demographics
NPI:1801625694
Name:DRIVER, KENDRIA (LCSW)
Entity type:Individual
Prefix:
First Name:KENDRIA
Middle Name:
Last Name:DRIVER
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 1:4762 JOBE TRL
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-7423
Mailing Address - Country:US
Mailing Address - Phone:718-440-7414
Mailing Address - Fax:
Practice Address - Street 1:4762 JOBE TRL
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-7423
Practice Address - Country:US
Practice Address - Phone:718-440-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN85731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical