Healthcare Provider Details

I. General information

NPI: 1992644231
Provider Name (Legal Business Name): KENDRA GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 N RACE ST
STATESVILLE NC
28677-3915
US

IV. Provider business mailing address

171 WAYPOINTE CIR APT 101
MOORESVILLE NC
28117-5496
US

V. Phone/Fax

Practice location:
  • Phone: 704-872-8931
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1284976
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: