# KENDALL INDIVIDUAL FAMILY AND MARRIAGE THERAPISTS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FOURTH STREET CHRISTIAN THERAPISTS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740830389
- **Authorized official:** JOY LYN KENDALL LMFT (PRESIDENT/OWNER)
- **Authorized official phone:** (707) 535-6615

## Contact information

- **Practice address:** 1622 4TH ST, SANTA ROSA, CA 95404-4020
- **Practice address phone:** (707) 571-1714
- **Mailing address:** 1622 4TH ST, SANTA ROSA, CA 95404-4020
- **Mailing address phone:** (707) 535-6615

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2019
- **Last updated:** 07/23/2024