Healthcare Provider Details

I. General information

NPI: 1295554418
Provider Name (Legal Business Name): KENDRA BROTT, LPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 GARDEN AVE STE 117
EUGENE OR
97403-1934
US

IV. Provider business mailing address

1901 GARDEN AVE STE 117
EUGENE OR
97403-1934
US

V. Phone/Fax

Practice location:
  • Phone: 541-514-3737
  • Fax:
Mailing address:
  • Phone: 541-514-3737
  • Fax:

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: KENDRA BROTT
Title or Position: OWNER
Credential: LPC
Phone: 541-514-3737