Provider Demographics
NPI:1063059301
Name:KENDRICK, ELIZABETH ILIFF (LCMHC, ATR-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ILIFF
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:LCMHC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:WAITSFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05673-6060
Mailing Address - Country:US
Mailing Address - Phone:802-595-3788
Mailing Address - Fax:
Practice Address - Street 1:4061 MAIN ST.
Practice Address - Street 2:
Practice Address - City:WAITSFIELD
Practice Address - State:VT
Practice Address - Zip Code:05673-6060
Practice Address - Country:US
Practice Address - Phone:802-595-3788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0134189101YM0800X
VT0680134189101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health