Kendra Vita, LPC

Individual provider Active NPI Professional Counselor · Eugene, OR

NPI 1245928902 · NPPES record last updated Apr 28, 2023

Key facts

NPI
1245928902
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
C7354 (OR)
Practice address
840 Lawrence St
Eugene, OR 97401-2828
Phone
(541) 968-3032
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C7354ORMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C7354 OR Yes

Addresses

Primary practice location

840 Lawrence St
Eugene, OR 97401-2828

Mailing address

815 Lawrence St Apt 10
Eugene, OR 97401-2868
Phone (541) 968-3032

Other providers in Eugene, OR

All providers in Eugene, OR · Professional Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.