Kynda C Canada, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.004440 Issued in IL

Practice address

501 W Elliott Ave
Springfield, IL 62702-3714

Phone

(217) 786-8361

Fax

(217) 775-0757

NPI assigned

Jan 23, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• KC Counseling Service

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1609712405
  NPD (past) Authorized official
• Keldermans Therapy Services, PLLC

  • Physical Therapy Clinic/Center
  • Springfield, IL
  • NPI 1659011468
  NPD (past)

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

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1891644837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BRISTOL RD",
            "city": "CHATHAM",
            "state": "IL",
            "postal_code": "626299635",
            "telephone_number": "217-299-1099",
            "fax_number": "217-775-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W ELLIOTT AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023714",
            "telephone_number": "217-786-8361",
            "fax_number": "217-775-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "KYNDA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.004440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libby Chanel Campbell, COTA
• Mary K. Campbell, M.D.
• Pamela A Campbell, MD
• Stacie Campbell X, LPC
• Carley Renee Campton, FNP-C
• Elizabeth Canas-Stanks, RBT
• Donna C Canavan, OTR/L
• Angela Dagnino Canedo, RBT
• Craig Canter, DMD
• Stacey Cantrell, LPC

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.