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General NPI Number Information
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NPI Number | 1881319648
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Entity Type | Individual
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Provider Name | KENDRA CROSDALE
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Gender | Female
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 213 W 35TH ST
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City | NEW YORK
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State | NY
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Zip | 10001-1903
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Country | US
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Telephone | 212-576-4104
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Fax |
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Provider Business Mailing Address
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Address Line | 2181 MADISON AVE APT 11C
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City | NEW YORK
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State | NY
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Zip | 10037-2337
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Country | US
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Telephone | 646-629-3697
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 117394-01
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License Number State | NY
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