FOURTH STREET CHRISTIAN THERAPISTS
NPI 1740830389
Marriage & Family Therapist in Santa Rosa, CA
About Fourth Street Christian Therapists NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FOURTH STREET CHRISTIAN THERAPISTS (NPI 1740830389) is a healthcare organization registered as a marriage & family therapist in Santa Rosa, California and active in the NPI registry since September 2019. The organization lists Joy Lyn Kendall, President/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fourth Street Christian Therapists is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Fourth Street Christian Therapists, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kendall Individual Family And Marriage Therapists Inc's NPI number?
The NPI number for Kendall Individual Family And Marriage Therapists Inc is 1740830389. It was assigned to this organization in the NPPES registry on September 16, 2019. The provider is doing business as Fourth Street Christian Therapists.
Where is Kendall Individual Family And Marriage Therapists Inc located?
Kendall Individual Family And Marriage Therapists Inc is located at 1622 4th St, Santa Rosa, CA 95404. The listed phone number is (707) 571-1714.
What is Kendall Individual Family And Marriage Therapists Inc's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Kendall Individual Family And Marriage Therapists Inc enrolled in Medicare?
Yes. Kendall Individual Family And Marriage Therapists Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kendall Individual Family And Marriage Therapists Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Kendall Individual Family And Marriage Therapists Inc, in Clinical Social Worker, Marriage and Family Therapist and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Kendall Individual Family And Marriage Therapists Inc was last updated on July 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Fourth Street Christian Therapists · NPI 1740830389
Marriage & Family Therapist organization in Santa Rosa, California. Organization record, active in the CMS NPPES registry since September 16, 2019.
## Identity
- **NPI:** 1740830389 (Entity type: Organization)
- **Enumerated:** September 16, 2019
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **Legal business name:** Kendall Individual Family And Marriage Therapists Inc
- **Organization subpart:** No
- **Authorized official:** Joy Kendall, PRESIDENT/OWNER
## Practice location
- **Address:** 1622 4TH ST, Santa Rosa, CA 95404-4020
- **Phone:** (707) 571-1714
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Marriage and Family Therapist (2), Mental Health Counselor (2), Clinical Social Worker (1); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 23, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1740830389) · Data from the CMS NPPES public registry.