Active NPI
Kendall Greene-Herron, LMSW
- Social Worker
- Gaithersburg, MD
National Provider Identifier
1417743741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 32787
- Practice address
- 9841 Washingtonian Blvd
Gaithersburg, MD 20878-5389 - Phone
- (833) 366-3934
- Fax
- (833) 630-0540
- NPI assigned
- Apr 15, 2025
- Last updated
- Apr 15, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | DC | ||
| Social Worker | 104100000X | VA | ||
| Social Worker | 104100000X | 32787 | MD | Primary |
Addresses
Primary practice location
9841 Washingtonian Blvd
Gaithersburg, MD 20878-5389
Mailing address
1039 Ola Dale Dr
McDonough, GA 30252-7196
Phone (404) 735-4050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32787 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1417743741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1039 OLA DALE DR",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302527196",
"telephone_number": "404-735-4050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9841 WASHINGTONIAN BLVD",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208785389",
"telephone_number": "833-366-3934",
"fax_number": "833-630-0540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE-HERRON",
"first_name": "KENDALL",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-15",
"last_updated": "2025-04-15",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "DC",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "32787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.