| Doctor Name: | MR. WILLIAM TODD KOLENDA |
| NPI Number: | 1336345404 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LPC, CCDP-D |
| License Number: | 2003020071 |
| Business Practice Address: | 13160 Country Rd St. James, MO - 655599989 |
| Business Phone Number: | 3149560094 |
| Business Fax Number: | |
| Mailing Address: | 435 West Kerr, SPRINGFIELD |
| State: | MO |
| Postal Code: | 65803 |
| Phone Number: | 4174960918 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2007 |
| NPI Last Update Date: | 08/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2003020071 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |