MEDICARE: ANN KENDIG MA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	161421	OH
2	101YP2500X	Professional Counselor	1921	KY
3	101YP2500X	Professional Counselor	E1200660	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	610661458	OTHER	KY	TAX ID

General Provider Information

NPI Number	:	1598174724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN KENDIG MA

Provider Business Mailing Address
First Line	:	7285 WILLOWOOD DR
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45241-3703
Country	:	US
Telephone Number	:	216-618-0054
Fax Number	:

Provider Business Practice Location Address
First Line	:	7686 CINCINNATI DAYTON RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1539
Country	:	US
Telephone Number	:	513-601-8289
Fax Number	:

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

Provider Enumeration Date	:	08/13/2014
Last Update Date	:	07/21/2022

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Directions to “ ANN KENDIG MA” Practice Location

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