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Individual

KENDRA RENEE GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED, LPCC

Contact information

Practice address
451 BIG HILL AVE STE 5, RICHMOND, KY 40475
(859) 482-7862
(859) 999-7869
Mailing address
PO BOX 802, BEREA, KY 40403-0802
(859) 428-7862
(859) 999-7869

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
168628
KY
101YM0800X
Mental Health Counselor
168628
KY
101YM0800X
Mental Health Counselor
Primary
269446
KY
101YP2500X
Professional Counselor
269446
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100728130
KY
Enumeration date
08/12/2016
Last updated
03/29/2021
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