MEDICARE: TD EDUCATIONAL SERVICES CORP

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

General Provider Information

NPI Number	:	1780404418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TD EDUCATIONAL SERVICES CORP

Provider Business Mailing Address
First Line	:	3701 COCOPLUM CIR
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33063-5934
Country	:	US
Telephone Number	:	954-951-3329
Fax Number	:

Provider Business Practice Location Address
First Line	:	8360 W OAKLAND PARK BLVD
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-7332
Country	:	US
Telephone Number	:	954-536-1456
Fax Number	:

Authorized Official
Title or Position	:	LICENSED THERAPIST/ OWNER
Name	:	DR. LATASHA SHANTE' KENDRICK
Credential	:	LMHC
Telephone Number	:	954-951-3329

Provider Enumeration Date	:	10/16/2024
Last Update Date	:	02/21/2025

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Directions to “TD EDUCATIONAL SERVICES CORP ” Practice Location

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