Kendal Kae Blackwelder Gulledge, LCSW, LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2485 N NC 16 Business Hwy Ste 100
Denver, NC 28037-8256

Phone

(704) 657-4665

NPI assigned

Oct 30, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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 Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JW Counseling, PLLCGroup PAC ID 7810336096, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JW Counseling PLLC

  • Community/Behavioral Health Agency
  • Denver, NC
  • NPI 1063279578

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1447655634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 ANDREW POINT DR",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280375455",
            "telephone_number": "704-657-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 N NC 16 BUSINESS HWY STE 100",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280378256",
            "telephone_number": "704-657-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEDGE",
        "first_name": "KENDAL",
        "middle_name": "KAE BLACKWELDER",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21179",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010491",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Mark Graham, PHD
• Mariah Dominique Graham, RN
• Allison Grayson, DPT
• Rachel Leigh Gregory, PA
• Guided Waters Counseling
• Prag Gupta, MD
• Susane Maher Habashi-Ahigian, M.D.
• Dylan Zhebreen Hagen, PHARMD
• Nicole Marie Hairston, LCMHC
• Viron Hale, PT, DPT, ATC,CSCS

• Clinical Social Worker in Denver, NC
• Providers in Denver, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.