Individual provider Active NPI

Kendra Lynice Lee

  • Clinical Social Worker
  • Gadsden, AL
National Provider Identifier
1558970947
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1621-4427C Issued in AL
Practice address
215 Walnut St Ste 2
Gadsden, AL 35901-5254
Phone
(251) 406-5886
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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 1621-4427C AL Primary

Addresses

Primary practice location

215 Walnut St Ste 2
Gadsden, AL 35901-5254

Mailing address

215 Walnut St Ste 2
Gadsden, AL 35901-5254
Phone (251) 406-5886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20230322002058 AL Practitioner - Clinical Social Worker 0941674550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russellville Hospital Inc.Group PAC ID 3476878489, 66 clinicians
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

15225 Hwy 43
Suite I
Russellville, AL 35653-1969
Phone (256) 331-2700

350 Sun Temple Dr
Madison, AL 35758-5919
Phone (256) 288-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1621-4427CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health, Inc. Clinical CurrentSince Apr 3, 2023 Accepting new patients
Legacy Counseling and Consulting Services LLC Clinical Current Accepting new patients
Russellville Hospital Inc CurrentSince May 16, 2023 Accepting new patients
Russellville Hospital Inc CurrentSince May 16, 2023 Accepting new patients

Locations

215 Walnut St
#2
Gadsden, AL 35901
Phone (256) 494-7036

350 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700

25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1558970947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 WALNUT ST STE 2",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015254",
            "telephone_number": "251-406-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 WALNUT ST STE 2",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015254",
            "telephone_number": "251-406-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENDRA",
        "middle_name": "LYNICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1621-4427C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.