Healthcare Provider Details

I. General information

NPI: 1033648043
Provider Name (Legal Business Name): REBECCA ANN KENDRICK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 04/11/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 COUNTY BLUFF DRIVE
BRANSON MO
65616
US

IV. Provider business mailing address

195 COUNTRY BLUFF DR
BRANSON MO
65616-8848
US

V. Phone/Fax

Practice location:
  • Phone: 913-530-4920
  • Fax:
Mailing address:
  • Phone: 913-530-4920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2017009213
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: