Provider Demographics
NPI:1336469428
Name:KENDALL, JENNIFER LYN (LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:KENDALL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3052 ENISGLEN DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-2009
Mailing Address - Country:US
Mailing Address - Phone:727-410-9797
Mailing Address - Fax:
Practice Address - Street 1:3052 ENISGLEN DR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2009
Practice Address - Country:US
Practice Address - Phone:727-410-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health