Active NPI
Jessica Kudary
- Clinical Social Worker
- Clarksville, TN
National Provider Identifier
1700433034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8704
- Practice address
- 782 Weatherly Dr
Clarksville, TN 37043-8941 - Phone
- (931) 645-3552
- NPI assigned
- Aug 21, 2019
- Last updated
- Oct 16, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 0000009264 | TN | |
| Clinical Social Worker | 1041C0700X | 8704 | TN | Primary |
Addresses
Primary practice location
782 Weatherly Dr
Clarksville, TN 37043-8941
Mailing address
782 Weatherly Dr
Clarksville, TN 37043-8941
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000009264 | TN | MD | Social Worker |
| 8704 | TN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760572800000",
"number": "1700433034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "782 WEATHERLY DR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370438941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "782 WEATHERLY DR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370438941",
"telephone_number": "931-645-3552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUDARY",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-21",
"last_updated": "2025-10-16",
"certification_date": "2025-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "0000009264",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "8704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.