Individual provider Active NPI

Gabrielle Pasua Kennard, LSCW-C

  • School Counselor
  • Elkton, MD
National Provider Identifier
1033457908
Registry record updated Jan 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
12818 Issued in MD
Practice address
200 Booth St
Elkton, MD 21921-5657
Phone
(410) 996-3450
NPI assigned
Jan 27, 2013
Last updated
Jan 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 12818 MD Primary

Addresses

Primary practice location

200 Booth St
Elkton, MD 21921-5657

Mailing address

200 Booth St
Elkton, MD 21921-5657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20130403000042 MD Practitioner - Clinical Social Worker 3173768769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Practice addresses (Care Compare)

106 Bow St
Elkton, MD 21921-5544
Phone (410) 398-4000

111 W High St
Elkton, MD 21921-8611

Merit-based Incentive Payment System (MIPS)

Final score
78.57 of 100Reported as group
Quality
59.34
Promoting interoperability
89
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12818MDMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Nov 11, 2016 Accepting new patients
Union Hospital of Cecil County CurrentSince Nov 11, 2016 Accepting new patients

Locations

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1359244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359244800000",
    "number": "1033457908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215657",
            "telephone_number": "410-996-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNARD",
        "first_name": "GABRIELLE",
        "middle_name": "PASUA",
        "credential": "LSCW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-27",
        "last_updated": "2013-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MD",
            "license": "12818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.