Kenneth Terrell Washington, PH.D

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Practice address

18237 Kedzie Ave
Homewood, IL 60430-1411

Phone

(708) 433-9779

NPI assigned

Jan 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Dr Kenneth T Washington PLLC

  • Counseling Psychologist
  • Homewood, IL
  • NPI 1649861014
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1295326668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18237 KEDZIE AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301411",
            "telephone_number": "708-433-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18237 KEDZIE AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301411",
            "telephone_number": "708-433-9779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 E 9th St Apt 603",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606054507",
            "country_code": "US",
            "telephone_number": "708-433-9779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "KENNETH",
        "middle_name": "TERRELL",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "connect@kwphd.com",
            "affiliation": "N",
            "address_1": "18237 Kedzie Ave",
            "city": "Homewood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604301411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Walton, FNP-BC, NP-C,
• Martin Ward, HIGH SCHOOL DIPLOMA
• Diana Washington-Hughey, LCPC
• Alexis Washington
• Cathalyn Washington
• Mary Elizabeth Waterloo
• Lizabeth Watman, MS,CCC-SPL
• Makeva Watson, LPC
• Cassandra L. Weaver
• Earnest Webb Jr., MSW PHD

• Counseling Psychologist in Homewood, IL
• Providers in Homewood, IL by specialty
• Counseling Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.