Provider Demographics
NPI:1982911038
Name:KENDALL, ANDREA CLAIRE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CLAIRE
Last Name:KENDALL
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 1:148 FAIRMONT DR
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-6604
Mailing Address - Country:US
Mailing Address - Phone:540-290-1924
Mailing Address - Fax:
Practice Address - Street 1:148 FAIRMONT DR
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-6604
Practice Address - Country:US
Practice Address - Phone:540-290-1924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical