=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073337051
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINDRED FAMILY COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/14/2024
-----------------------------------------------------
Last Update Date | 11/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 SAINT THOMAS WAY
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433-1532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-338-5950
-----------------------------------------------------
Fax | 985-249-2514
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1775 N COLUMBIA ST
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433-5632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-338-5950
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AUNDI BARABINO
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 985-338-5950
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------