Provider Demographics
NPI:1932537560
Name:BARRY, KENDALL MARCELE (LPC)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:MARCELE
Last Name:BARRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1746 GROVENBERG CT
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49097-7776
Mailing Address - Country:US
Mailing Address - Phone:269-366-0161
Mailing Address - Fax:
Practice Address - Street 1:614 ROMENCE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-3613
Practice Address - Country:US
Practice Address - Phone:269-615-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional