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NPI 1073283461

NPI 1073283461 : KENDYL KISSELL LCPC : COEUR D ALENE, ID

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General NPI Number Information
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    NPI Number           |    1073283461
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    Entity Type          |    Individual 
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    Provider Name        |    KENDYL KISSELL LCPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/16/2021
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    Last Update Date     |    12/04/2025
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Provider Practice Location Address
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    Address Line         |    919 W CANFIELD AVE 
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    City                 |    COEUR D ALENE
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    State                |    ID
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    Zip                  |    83815-9764
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    Country              |    US
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    Telephone            |    208-758-0560
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    919 W CANFIELD AVE 
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    City                 |    COEUR D ALENE
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    State                |    ID
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    Zip                  |    83815-9764
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    Country              |    US
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    Telephone            |    208-758-0560
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    Fax                  |    
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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       |    9201
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    License Number State |    ID
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