Provider Demographics
NPI:1427790922
Name:KENDRICK, JOHN PAUL (LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:KENDRICK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 W RUSSET GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3827
Mailing Address - Country:US
Mailing Address - Phone:281-825-2303
Mailing Address - Fax:
Practice Address - Street 1:171 W RUSSET GROVE CIR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-3827
Practice Address - Country:US
Practice Address - Phone:281-209-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1035751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical