Kendra Docker, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401017302 Issued in MI

Practice address

1953 Ketegawn Rd
Owosso, MI 48867-1529

Phone

(720) 220-8106

NPI assigned

Oct 8, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kendra Drake Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Soul Garden Counseling LLC

  • Counselor
  • Owosso, MI
  • NPI 1073228805
  Medicare reassignment NPD

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1699316976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 KETEGAWN RD",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 KETEGAWN RD",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671529",
            "telephone_number": "720-220-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKER",
        "first_name": "KENDRA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401017302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "DRAKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Allen Dickenson
• Emily Dilts
• Shawn Marie Dilts, LMSW
• Ngoc-Cam Dinh
• Katie Dobski
• Charles William Dodge, PLC
• Matthew Dohring
• Melissa Dohring, OTR/L
• David C Dotson, MD
• Clinton Douglas III, CPHT

• Counselor in Owosso, MI
• Providers in Owosso, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.