Individual provider Active NPI

Kyndal Alexis Lafortune

  • Social Worker
  • College Park, MD
National Provider Identifier
1164099016
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
8400 Baltimore Ave Ste 300
College Park, MD 20740-2496
Phone
(240) 670-4050
NPI assigned
Jun 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

8400 Baltimore Ave Ste 300
College Park, MD 20740-2496

Mailing address

19023 Highstream Dr
Germantown, MD 20874-6134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28023MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Services, Inc. Current Accepting new patients
Way Station, Inc. Current Accepting new patients
Family Services, Inc. CurrentSince Jan 3, 2025 Accepting new patients
Family Services, Inc CurrentSince Jan 3, 2025 Accepting new patients
Mosaic Community Services CurrentSince Jan 3, 2025 Accepting new patients
Mosaic Community Services, Inc CurrentSince Jan 3, 2025 Accepting new patients
Choice Clinical Services, LLC PastSince Nov 16, 2021 Accepting new patients

Locations

2225 N Charles St
Baltimore, MD 21218
Phone (410) 366-4360

210 Abrecht Pl
Frederick, MD 21701
Phone (301) 663-8263

610 E Diamond Ave
Ste 100
Gaithersburg, MD 20877
Phone (301) 840-2000

328 N Potomac St
Hagerstown, MD 21740
Phone (410) 740-1901

1925 Greenspring Dr
Timonium, MD 21093

1931 Greenspring Dr
Timonium, MD 21093

288 E Green St
Westminster, MD 21157
Phone (410) 751-5970

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1164099016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19023 HIGHSTREAM DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208746134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 BALTIMORE AVE STE 300",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207402496",
            "telephone_number": "240-670-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFORTUNE",
        "first_name": "KYNDAL",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, MD

Sources for this page

Verify at the official NPI Registry.