Kentrell Deandre Washington, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12130123 Issued in WI

Practice address

1732 N Prospect Ave Apt 207
Milwaukee, WI 53202-1945

Phone

(920) 728-2361

NPI assigned

Nov 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, WI

  Medicare reassignment NPD
• Multicultural Trauma and Addiction Treatment Center of Wisconsin

  • Professional Counselor
  • Wauwatosa, WI
  • NPI 1376013516
  NPD (past)

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1023612975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 N PROSPECT AVE APT 207",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021945",
            "telephone_number": "920-728-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 N PROSPECT AVE APT 207",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021945",
            "telephone_number": "920-728-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "KENTRELL",
        "middle_name": "DEANDRE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-22",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12130123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity Washington
• Curetia Washington
• Heaven Washington
• Janie M Washington, MD
• Jessica R Washington
• Latika Nicole Washington, CSAC, ICS, LPC-IT
• Lynnette Washington
• Qiana Marie Washington
• Samantha E Washington, PSSYD
• Tenille Washington, MS,MED

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.