Jackimczyk, Kendra

Jackimczyk, Kendra is an individual health care provider with primary practice located at 7364 E Nopal Ave , Mesa AZ 85209-7220. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackimczyk, Kendra can be contacted via phone (480) 495-7979.

Contact Information

Primary practice address
7364 E Nopal Ave Mesa AZ 85209-7220
Phone: (480) 495-7979
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-10166 Arizona

Profile Details

NPI number 1780732990
LBN Legal business name Jackimczyk, Kendra
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Feb 15th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780732990 NPPES
Arizona MEDICAID 687296

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