NPIMap

Organization Active NPI

Woodworth Psychological Services, LLC

Doing business as Learning and Language Specialists

  • Clinical Psychologist
  • Golden Valley, MN
National Provider Identifier
1699289926
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP6072 Issued in MN
Legal business name
WOODWORTH PSYCHOLOGICAL SERVICES, LLC
Doing business as
Learning and Language Specialists
Practice address
1405 Lilac Dr N Ste 200
Golden Valley, MN 55422-4546
Phone
(763) 545-7708
Fax
(763) 545-3479
NPI assigned
Nov 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Authorized official

Name
Dr. Kendra Ann Woodworth, PSYDNPI 1164966560
Title
President/Licensed Psychologist
Phone
(612) 206-2735

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X LP6072 MN Primary

Addresses

Primary practice location

1405 Lilac Dr N Ste 200
Golden Valley, MN 55422-4546

Mailing address

1405 Lilac Dr N Ste 200
Golden Valley, MN 55422-4546
Phone (763) 545-7708

Other names 1

  • Learning and Language Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

1405 Lilac Dr N
Ste 200
Minneapolis, MN 55422
Phone (763) 545-3479

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1699289926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N STE 200",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224546",
            "telephone_number": "763-545-7708",
            "fax_number": "763-545-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N STE 200",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224546",
            "telephone_number": "763-545-7708",
            "fax_number": "763-545-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWORTH PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "WOODWORTH",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-206-2735",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Learning and Language Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.