Theresa Grodi-Kennon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

002928 Issued in FL

Practice address

341 Brantley Club PL
Longwood, FL 32779-5873

Phone

(407) 718-2185

NPI assigned

Apr 29, 2022

Last updated

Apr 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1396480877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 BRANTLEY CLUB PL",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795873",
            "telephone_number": "407-718-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 BRANTLEY CLUB PL",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795873",
            "telephone_number": "407-718-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODI-KENNON",
        "first_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "002928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Greco, MSW, LCSW
• Isabel Stephanie Greicius
• Teresa Grimes, M.S., CCC-SLP
• Joseph Granger Grimsley IV, RMHCI
• Christine Grissom, MD
• Diane Grose, MA LMHC
• Joan R. Grossenbacher, ARNP
• Growthera, LLC
• Guardian Care Services of Brevard
• Guidewell Sanitas I, LLC

• Clinical Social Worker in Longwood, FL
• Providers in Longwood, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.