Kendra R Henry LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

KENDRA R HENRY LLC

Practice address

2212 2ND St SW Unit 1
Rochester, MN 55902-4421

Phone

(507) 258-4458

Fax

(507) 899-9577

NPI assigned

Nov 20, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kendra Ruth Henry, LPCNPI 1023432747

Title

Owner

Phone

(507) 358-8678

Specialties & licenses 1

Addresses

Other names 1

• ENLIVEN PSYCH HEALTH Other name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendra Henry, LPCC, LADC

  • Professional Counselor
  • Rochester, MN
  • NPI 1023432747
  Medicare reassignment NPD Authorized official
• Crystal Marie Guyse, LP, LICSW

  • Psychologist
  • Rochester, MN
  • NPI 1265676258

  Professional

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1265257521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 2ND ST SW UNIT 1",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024421",
            "telephone_number": "507-258-4458",
            "fax_number": "507-899-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 2ND ST SW UNIT 1",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024421",
            "telephone_number": "507-258-4458",
            "fax_number": "507-899-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDRA R HENRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-358-8678",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENLIVEN PSYCH HEALTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ken Wadum, Ed.D. LP
• Maral D Kenderian, MD
• Saad J Kenderian, MD
• Vera Kenderian, DDS
• Mustafa Kendi, M.D.
• Michael L Kendrick, M.D.
• Ryan William Kendziora, MD
• April M Kennedy, CRNA
• Cassie C Kennedy, M.D.
• Charles C Kennedy, M.D.

• Professional Counselor in Rochester, MN
• Providers in Rochester, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.