Provider Demographics
NPI:1194952937
Name:ENZINGER, KENDOL RENEA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KENDOL
Middle Name:RENEA
Last Name:ENZINGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 LISA LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-8207
Mailing Address - Country:US
Mailing Address - Phone:317-213-8081
Mailing Address - Fax:
Practice Address - Street 1:3681 LISA LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-8207
Practice Address - Country:US
Practice Address - Phone:317-213-8081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53021104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker