Individual provider Active NPI

Zachary Adam Kendrick, PRSS-SUD

  • Peer Specialist
  • Williamson, WV
National Provider Identifier
1457265795
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
23-9184 Issued in WV
Practice address
101 Logan St Ste 201
Williamson, WV 25661-3639
Phone
(304) 235-3570
Fax
(304) 235-2654
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 23-9184 WV Primary

Addresses

Primary practice location

101 Logan St Ste 201
Williamson, WV 25661-3639

Mailing address

101 Logan St Ste 201
Williamson, WV 25661-3639
Phone (304) 235-3570

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1457265795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LOGAN ST STE 201",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613639",
            "telephone_number": "304-235-3570",
            "fax_number": "304-235-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LOGAN ST STE 201",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613639",
            "telephone_number": "304-235-3570",
            "fax_number": "304-235-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "ZACHARY",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "PRSS-SUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WV",
            "license": "23-9184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.