MEDICARE: KENDRA TALLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH22053	FL

General Provider Information

NPI Number	:	1386366870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA TALLEY

Provider Business Mailing Address
First Line	:	2474 RUMBA CT APT 3
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32304-1521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2474 RUMBA CT APT 3
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32304-1521
Country	:	US
Telephone Number	:	850-544-5813
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	10/31/2025

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Directions to “ KENDRA TALLEY ” Practice Location

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