Provider Demographics
NPI:1174214019
Name:SCOTT, KENDRA DANYEL (LGPC)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:DANYEL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 RHODE ISLAND AVE NE APT 408
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2843
Mailing Address - Country:US
Mailing Address - Phone:202-297-7306
Mailing Address - Fax:
Practice Address - Street 1:4801 BENNING RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-6145
Practice Address - Country:US
Practice Address - Phone:202-582-5477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC101YS0200X
DCLGPC00791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool