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General NPI Number Information
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NPI Number | 1023432747
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Entity Type | Individual
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Provider Name | KENDRA HENRY LPCC, LADC
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Gender | Female
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Dates
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Enumeration Date | 02/17/2014
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2212 2ND ST SW UNIT 1
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City | ROCHESTER
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State | MN
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Zip | 55902-4421
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Country | US
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Telephone | 507-258-4458
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Fax | 507-299-9577
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Provider Business Mailing Address
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Address Line | 2212 2ND ST SW UNIT 1
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City | ROCHESTER
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State | MN
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Zip | 55902-4421
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Country | US
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Telephone | 507-258-4458
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Fax | 507-299-9577
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1264
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC01264
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 303799
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License Number State | MN
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