Kendra Ann Woodworth, PSYD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6072 Issued in MN

Practice address

1405 Lilac Dr N
Suite 200
Golden Valley, MN 55422-4535

Phone

(763) 545-7708

Fax

(763) 545-3479

NPI assigned

Dec 5, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 20, 2023 through Aug 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Woodworth Psychological Services, LLC

  dba Learning and Language Specialists

  • Clinical Psychologist
  • Golden Valley, MN
  • NPI 1699289926
  NPD (past) Authorized official
• Learning and Language Specialists, Inc.

  • Clinical Neuropsychologist
  • Minneapolis, MN
  • NPI 1912022336
  NPD (past)

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1164966560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N",
            "address_2": "SUITE 200",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224535",
            "telephone_number": "763-545-7708",
            "fax_number": "763-545-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N",
            "address_2": "SUITE 200",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224535",
            "telephone_number": "763-545-7708",
            "fax_number": "763-545-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWORTH",
        "first_name": "KENDRA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Wittersen, P.T.
• Amanda Rose Woelfel Padilla, LICSW
• Laura A Wolf
• Ann Laurie Woodruff, LICSW
• Woodworth Psychological Services, LLC (Learning and Language Specialists)
• Sheila Kaye Woolhiser
• Rebecca Worthington
• Judy Wright
• Elaine R. Wynne
• Mary Xiong

• Clinical Psychologist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.