Provider Demographics
NPI:1598841785
Name:HUBBARD, KENDRA JO (MS LIMHP)
Entity type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:JO
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MS LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7121 A ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4289
Mailing Address - Country:US
Mailing Address - Phone:402-937-3565
Mailing Address - Fax:402-327-0343
Practice Address - Street 1:7121 A ST STE 202
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4289
Practice Address - Country:US
Practice Address - Phone:402-937-3565
Practice Address - Fax:402-327-0343
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE084692OtherBCBS
NE11192OtherMIDLANDS CHOICE