Individual provider Active NPI

Kendra Leeann Stinson, LICSW

  • Clinical Social Worker
  • Woburn, MA
National Provider Identifier
1558959775
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114145 Issued in MA
Practice address
55 Locust St
Woburn, MA 01801-3814
Phone
(781) 937-8233
NPI assigned
Jan 4, 2021
Last updated
Apr 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114145 MA Primary

Addresses

Primary practice location

55 Locust St
Woburn, MA 01801-3814

Mailing address

55 Locust St
Woburn, MA 01801-3814
Phone (781) 937-8233

Other practice location 1

42 Pasture Rd
Reading, MA 01867-1237
Phone (303) 550-7607

Other identifiers 1

IdentifierTypeStateIssuer
114145OtherMADIVISION OF PROFESSIONAL LICENSURE BOARD OF SOCIAL WORKERS

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

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1558959775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LOCUST ST",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013814",
            "telephone_number": "781-937-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LOCUST ST",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013814",
            "telephone_number": "781-937-8233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Pasture Rd",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "MA",
            "postal_code": "018671237",
            "country_code": "US",
            "telephone_number": "303-550-7607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STINSON",
        "first_name": "KENDRA",
        "middle_name": "LEEANN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF PROFESSIONAL LICENSURE BOARD OF SOCIAL WORKERS",
            "identifier": "114145",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.