=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598675175
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KENDRA ZITTLAU LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2026
-----------------------------------------------------
Last Update Date | 09/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 220 S CLIFF AVE STE 126
-----------------------------------------------------
City | HARRISBURG
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57032-2485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-412-4324
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6113 W SIOUX K CT
-----------------------------------------------------
City | SIOUX FALLS
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57106-0478
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 712-230-4326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 21041
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------