Individual provider Active NPI

Kendall Greene-Herron, LMSW

  • Social Worker
  • Gaithersburg, MD
National Provider Identifier
1417743741
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
32787 Issued in MD
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, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
32787MDMDSocial 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.

Verify at the official NPI Registry.