Individual provider Active NPI

Kennedy Haverland, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1053009464
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2025-0878 Issued in NM
Practice address
9007 Washington St NE
Albuquerque, NM 87113-2722
Phone
(505) 585-2048
NPI assigned
Apr 25, 2023
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2025-0878 NM Primary

Addresses

Primary practice location

9007 Washington St NE
Albuquerque, NM 87113-2722

Mailing address

9007 Washington St NE
Albuquerque, NM 87113-2722
Phone (505) 585-2048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20251009005052 NM Practitioner - Clinical Social Worker 1456858802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4619 Brookwood St NE
Albuquerque, NM 87109-2803

9007 Washington St NE
Albuquerque, NM 87113-2705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Mental Health, LLC Clinical CurrentSince Sep 1, 2025 Accepting new patients
New Mexico Dream Center of Albuquerque Social Worker Current Accepting new patients

Locations

126 General Chennault St NE
Albuquerque, NM 87123
Phone (505) 332-8935

2601 Wyoming Blvd NE
Ste 208
Albuquerque, NM 87112
Phone (505) 503-0272

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": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1053009464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9007 WASHINGTON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132722",
            "telephone_number": "505-585-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9007 WASHINGTON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132722",
            "telephone_number": "505-585-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERLAND",
        "first_name": "KENNEDY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2025-0878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.