Dr Kenneth T Washington PLLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

DR KENNETH T WASHINGTON PLLC

Doing business as

Dr Kenneth T Washington LLC

Practice address

18237 Kedzie Ave
Homewood, IL 60430-1411

Phone

(708) 433-9779

NPI assigned

Jan 28, 2021

Last updated

Nov 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth T WashingtonNPI 1295326668

Title

Director

Phone

(708) 433-9779

Specialties & licenses 1

Addresses

Other names 1

• Dr Kenneth T Washington LLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Terrell Washington, PH.D

  • Counseling Psychologist
  • Homewood, IL
  • NPI 1295326668
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1649861014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18237 KEDZIE AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301411",
            "telephone_number": "708-433-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18237 KEDZIE AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301411",
            "telephone_number": "708-433-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR KENNETH T WASHINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-433-9779"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "connect@kwphd.com",
            "affiliation": "N",
            "address_1": "18237 Kedzie Ave",
            "city": "Homewood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604301411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dr Kenneth T Washington LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr Kenneth T Washington LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Counseling Psychologist in Homewood, IL
• Providers in Homewood, IL by specialty
• Counseling Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.