Jasper, Kendall

Jasper, Kendall is an sole proprietor health care provider with primary practice located at 223 W Morehead St , Charlotte NC 28202-1521. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Agencies / Community/Behavioral Health. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Jasper, Kendall can be contacted via phone (980) 819-5692.

Contact Information

Primary practice address
223 W Morehead St Charlotte NC 28202-1521
Phone: (980) 819-5692
Fax: (980) 819-5694
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 4088 North Carolina
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 4088 North Carolina
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 4088 North Carolina
Agencies / Community/Behavioral Health 251S00000X 4088 North Carolina

Profile Details

NPI number 1720106743
LBN Legal business name Jasper, Kendall
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 27th, 2007
Last updated Apr 4th, 2016 - about 10 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 1720106743 NPPES
North Carolina MEDICAID 6107205

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