Healthcare Provider Details

I. General information

NPI: 1972427599
Provider Name (Legal Business Name): KENDALL ELIZABETH KRUSZEWSKI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 VISTADALE CT
TUCKER GA
30084-5417
US

IV. Provider business mailing address

539 BLAKE AVE SE
ATLANTA GA
30316-2000
US

V. Phone/Fax

Practice location:
  • Phone: 404-585-8878
  • Fax:
Mailing address:
  • Phone: 404-550-4712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number596579
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number017055
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: