Individual
MS. KENDRA LYNN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1805 S BALSAM ST, LAKEWOOD, CO 80232-6700
(303) 980-5500
Mailing address
4860 ROBB ST, SUITE 201, WHEAT RIDGE, CO 80033-2184
(303) 278-7418
(888) 341-5050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1475
CO
1041C0700X
Clinical Social Worker
22582
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11825032
CAQH PIN
CO
01
—
1475
PROFESSIONAL LICENSE
CO
05
—
25900285
—
CO
Enumeration date
05/03/2007
Last updated
10/08/2013
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