Healthcare Provider Details

I. General information

NPI: 1619494630
Provider Name (Legal Business Name): KENDRA NICOLE HEMMINGER LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDRA NICOLE GORMAN KENDRA GORMAN

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 PUBLIC SQ
TROY OH
45373-3272
US

IV. Provider business mailing address

2055 SWAILES RD
TROY OH
45373-9248
US

V. Phone/Fax

Practice location:
  • Phone: 937-998-4714
  • Fax:
Mailing address:
  • Phone: 937-474-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1901486-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: