Provider Demographics
NPI:1932335510
Name:MCGIVNEY, KENDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:MCGIVNEY
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 1:240 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-5418
Mailing Address - Country:US
Mailing Address - Phone:562-599-9271
Mailing Address - Fax:562-218-6578
Practice Address - Street 1:3605 LONG BEACH BLVD STE 331
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4025
Practice Address - Country:US
Practice Address - Phone:562-989-0537
Practice Address - Fax:562-989-0573
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA298521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program