Autumn Rose Kendal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC20123 Issued in ME

Practice address

268 Stillwater Ave
Bangor, ME 04401-3980

Phone

(207) 973-6100

NPI assigned

Sep 21, 2018

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.

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1205310638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013980",
            "telephone_number": "207-973-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013980",
            "telephone_number": "207-973-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 Stillwater Ave",
            "address_purpose": "LOCATION",
            "city": "Old Town",
            "state": "ME",
            "postal_code": "044681665",
            "country_code": "US",
            "telephone_number": "207-404-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDAL",
        "first_name": "AUTUMN",
        "middle_name": "ROSE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cavenaugh Kelly, OT
• Michaela Beatrie Kelly, PA-C
• Victor A Kelmenson, MD
• Courtney Kelsey, RN
• Kemet Health One LLC
• Keith S Kendall, DPM
• Patricia L. Kennedy, CRNA
• Catherine M Kenney, DPT
• Olena Kenney, CADC
• Darlene Marie Kenny

• Clinical Social Worker in Bangor, ME
• Providers in Bangor, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.