Provider Demographics
NPI:1871366906
Name:GIGLIOTTI, KENDALL (LMSW)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:GIGLIOTTI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7144 LAWGIVER CIR
Mailing Address - Street 2:
Mailing Address - City:CORRYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37721-2558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7144 LAWGIVER CIR
Practice Address - Street 2:
Practice Address - City:CORRYTON
Practice Address - State:TN
Practice Address - Zip Code:37721-2558
Practice Address - Country:US
Practice Address - Phone:501-830-7101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14516104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty