Healthcare Provider Details

I. General information

NPI: 1487579314
Provider Name (Legal Business Name): KENDRICK WOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 NORTH ST STE 300
CANANDAIGUA NY
14424-1075
US

IV. Provider business mailing address

1600 EDGEWOOD AVE
ROCHESTER NY
14618-5412
US

V. Phone/Fax

Practice location:
  • Phone: 585-394-0530
  • Fax: 585-394-3872
Mailing address:
  • Phone: 585-394-0530
  • Fax: 585-394-3872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: