KENDRIC DOMINICK (NPI# 1003354127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003354127 |
| Entity Type | Individual |
| Full Name | KENDRIC DOMINICK |
| Practice Address |
5447 W Sunset Hill Ave Baton Rouge LA 70805-3215 |
| Mailing Address |
5447 W. Sunset Hill Baton Rouge LA 70805 |
| Practice Telephone | 3188402574 |
| Mailing Telephone | 3188402574 |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 0000000 | 05 |
| Street Address |
5447 W SUNSET HILL AVE |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70805-3215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306481445 | Upgrade Group Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3719 Katherine Ave, 3719 Katherine Ave, Baton Rouge, LA 70805 | 2019-11-13 |
| 1164991899 | Hip Hop Barbers, LLC | Specialist | 5709 Hollywood Crossover St, Baton Rouge, LA 70805 | 2018-11-26 |
| 1093234783 | Omar Feme Braggs I | Counselor | 3973 Choctaw Drive, Baton Rouge, LA 70805 | 2017-09-13 |
| 1558883116 | Jeffrey Williams | Counselor | 3456 Eaton Street, Baton Rouge, LA 70805 | 2017-07-14 |
| 1215466628 | Angel Danielle Morgan | Counselor | 3540 Ontario St., Baton Rouge, LA 70805 | 2017-06-08 |
| 1376904151 | Mama's Medical Transportation | Non-emergency Medical Transport (VAN) | 2727 North Ardenwood Dr., Baton Rouge, LA 70805 | 2016-03-08 |
| 1013389105 | Tiffany Thomas | Counselor | 8325 Kelwood Avenue, Baton Rouge, LA 70805 | 2015-10-28 |
| 1366823395 | Travia Linette Washington | Community Health Worker | 2959 Sherwood St, Baton Rouge, LA 70805 | 2015-06-16 |
| 1295000164 | Capital Area Human Services District | Substance Abuse Rehabilitation Facility | 2455 Wooddale Blvd., Baton Rouge, LA 70805 | 2012-03-12 |
| 1427332238 | Carl P Thibodeaux | Pharmacist | 5889 Airline Highway, Baton Rouge, LA 70805 | 2011-09-29 |
| Find all providers in zip 70805 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840444 | Bradford J Williams | Counselor | 624 S 16th St, Baton Rouge, LA 70802-4011 | 2020-10-28 |
| 1255947883 | Vanessa Brown | Counselor | 12438 Lockhaven Ave, Baton Rouge, LA 70815-6537 | 2020-09-18 |
| 1588287809 | Catherine Vicknair | Counselor | 8755 Sullivan Rd Ste 3a, Baton Rouge, LA 70818-6031 | 2020-05-20 |
| 1174144596 | Feleshia N Borskey Young | Counselor | 3940 Prescott Rd Ste A, Baton Rouge, LA 70805-5143 | 2020-04-27 |
| 1396208617 | Trinette Amelia Jackson | Counselor | 4336 North Blvd Ste 104, Baton Rouge, LA 70806-3920 | 2019-04-12 |
| 1639632169 | Ezekiel Alsander | Counselor | 6929 Commerce Cir Apt 6101, Baton Rouge, LA 70809-1887 | 2019-04-11 |
| 1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
| 1386101764 | Joseph Stevenson | Counselor | 6245 Cedar Grove Dr, Baton Rouge, LA 70812-1730 | 2019-02-21 |
| 1891252276 | Laketa Smith | Counselor | 8365 Siegen Ln Apt 4, Baton Rouge, LA 70810-1901 | 2019-02-21 |
| 1083170500 | Lashona Latrice Alexander | Counselor | 4845 Jamestown Ave Ste 208, Baton Rouge, LA 70808-3248 | 2019-02-20 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.