MR. KELLY KENDRICKS (NPI# 1548872765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548872765 |
| Entity Type | Individual |
| Full Name | MR. KELLY KENDRICKS |
| Practice Address |
2002 Atwood Ave Ste 225 Madison WI 53704-5382 |
| Mailing Address |
111 Acker Ct Verona WI 53593-2251 |
| Practice Telephone | 6084165245 |
| Practice Fax Number | 6084165221 |
| Mailing Telephone | 6086096761 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
4714-226 | WI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2021 Atwood Ave, Madison, WI 537045324 | 6082444859 |
| Street Address |
2002 ATWOOD AVE STE 225 |
| City | MADISON |
| State | WI |
| Zip Code | 53704-5382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710591086 | Carrie Allen | Counselor | 222 Kyser Blvd Apt 73, Madison, AL 35758-2307 | 2020-09-03 |
| 1740803097 | Megan Gour | Counselor | 8102 Wellness Way, Madison, WI 53719-8800 | 2020-05-21 |
| 1578197141 | Nicole Danielle Morra | Counselor | 141 Durham Rd Ste 19, Madison, CT 06443-2657 | 2020-02-23 |
| 1982236741 | Jolin Mitchel | Counselor | 437 S Yellowstone Dr Ste 219, Madison, WI 53719-1061 | 2020-02-10 |
| 1346880127 | Tree of Life Treatment Services | Counselor | 437 S Yellowstone Dr Ste 200, Madison, WI 53719-2902 | 2020-01-09 |
| 1720623226 | Reflections Mental Health LLC | Counselor | 2802 Coho St Ste 203, Madison, WI 53713-4521 | 2019-11-08 |
| 1740822287 | Diamond Jones | Counselor | 2093 W Us 90, Madison, FL 32340-4308 | 2019-10-16 |
| 1457819617 | Emma Coleen Tagariello | Counselor | 170 Ridgedale Ave, Madison, NJ 07940-1220 | 2019-03-06 |
| 1144785940 | Vallis LLC | Counselor | 814 Palmer Rd Ste B4, Madison, AL 35758-3185 | 2019-02-05 |
| 1114400694 | Kristin Schmidt | Counselor | 700 Ray O Vac Dr Ste 320, Madison, WI 53711-2471 | 2018-09-11 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.