Provider Demographics
NPI:1639293384
Name:GILBERT, KENDRA H (LPC)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:H
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 DAHLONEGA ST
Mailing Address - Street 2:SUITE 1801 A
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2480
Mailing Address - Country:US
Mailing Address - Phone:678-371-7357
Mailing Address - Fax:678-807-2841
Practice Address - Street 1:327 DAHLONEGA ST
Practice Address - Street 2:SUITE 1801 A
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2480
Practice Address - Country:US
Practice Address - Phone:678-371-7357
Practice Address - Fax:678-807-2841
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC04119101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional