Provider Demographics
NPI:1730424714
Name:KENDRICK, MEGAN M (LMSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:M
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:FILLMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:812 E JOLLY RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6818
Mailing Address - Country:US
Mailing Address - Phone:517-346-8000
Mailing Address - Fax:517-346-8291
Practice Address - Street 1:812 E JOLLY RD
Practice Address - Street 2:SUITE 216
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-6818
Practice Address - Country:US
Practice Address - Phone:517-346-9522
Practice Address - Fax:517-346-8171
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010921401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical