Phoumivong, Kendra D

Phoumivong, Kendra D is an individual health care provider with primary practice located at 690 Courtenay Dr Ne , Atlanta GA 30306-3421. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Phoumivong, Kendra D can be contacted via phone (404) 875-4551.

Contact Information

Primary practice address
690 Courtenay Dr Ne Atlanta GA 30306-3421
Phone: (404) 875-4551
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 8033-M Arkansas
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8033-C Arkansas
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW006876 Georgia

Profile Details

NPI number 1336596931
LBN Legal business name Phoumivong, Kendra D
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2016
Last updated Jan 31st, 2023 - about 3 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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