Individual provider Active NPI

Mary E Kennard, LCSW

  • Clinical Social Worker
  • Newark, DE
National Provider Identifier
1790581031
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0012601 Issued in DE
Practice address
4735 Ogletown Stanton Rd Ste 1201
Newark, DE 19713-2089
Phone
(302) 623-4330
Fax
(302) 623-4338
NPI assigned
Feb 19, 2025
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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 Q1-0012601 DE Primary

Addresses

Primary practice location

4735 Ogletown Stanton Rd Ste 1201
Newark, DE 19713-2089

Mailing address

4735 Ogletown Stanton Rd Ste 1201
Newark, DE 19713-2089
Phone (302) 623-4330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20250228002447 DE Practitioner - Clinical Social Worker 3476073867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

100 Sunnyside Rd
Smyrna, DE 19977-1752
Phone (302) 653-1900

4745 Ogletown Stanton Rd
Newark, DE 19713-2074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0012601DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc CurrentSince Jan 20, 2025 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Jan 20, 2025 Accepting new patients

Locations

4735 Ogletown Stanton Rd
Ste 1201
Newark, DE 19713
Phone (302) 623-4330

100 Sunnyside Rd
#2
Smyrna, DE 19977
Phone (302) 653-1900

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1790581031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 1201",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132089",
            "telephone_number": "302-623-4330",
            "fax_number": "302-623-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 1201",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132089",
            "telephone_number": "302-623-4330",
            "fax_number": "302-623-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNARD",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0012601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.