Provider Demographics
NPI:1104426725
Name:PERKINS, KENDELLE (LPCC)
Entity type:Individual
Prefix:
First Name:KENDELLE
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7614 HINTON AVE S APT 7
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-5755
Mailing Address - Country:US
Mailing Address - Phone:612-719-0724
Mailing Address - Fax:
Practice Address - Street 1:3802A GRAND AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1233
Practice Address - Country:US
Practice Address - Phone:612-709-0724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor