Individual provider Active NPI

Kendra Pearl Alex, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1629604194
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17131 Issued in FL
Practice address
2181 Orange Ave E
Tallahassee, FL 32311-6144
Phone
(832) 317-7471
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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 17131 FL Primary

Addresses

Primary practice location

2181 Orange Ave E
Tallahassee, FL 32311-6144

Mailing address

2181 Orange Ave E
Tallahassee, FL 32311-6144
Phone (832) 317-7471

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
17131FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Living Free Counseling, LLC Clinical CurrentSince Aug 1, 2021 Accepting new patients
Florida First Psychiatry Specialist LLC PastSince Mar 29, 2021 Accepting new patients

Organizations & group practices 2

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": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1629604194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 ORANGE AVE E",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323116144",
            "telephone_number": "832-317-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 ORANGE AVE E",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323116144",
            "telephone_number": "832-317-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEX",
        "first_name": "KENDRA",
        "middle_name": "PEARL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.