Healthcare Provider Details

I. General information

NPI: 1417699604
Provider Name (Legal Business Name): KATHRYN KENDALL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W OSBORN RD # 1017
PHOENIX AZ
85013-3909
US

IV. Provider business mailing address

106 W OSBORN RD # 1017
PHOENIX AZ
85013-3909
US

V. Phone/Fax

Practice location:
  • Phone: 619-665-4387
  • Fax:
Mailing address:
  • Phone: 619-665-4378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT142910343902
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT140530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: