Kindell Weatherford, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

109090 Issued in TX

Practice address

4200 Stuart St
Greenville, TX 75401-5759

Phone

(903) 455-3987

Fax

(903) 455-0834

NPI assigned

Nov 17, 2025

Sex

Female

Sole proprietor

No

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

Enrolled in TX

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lakes Regional Mental Health Mental Retardation Center

  • Community/Behavioral Health Agency
  • Terrell, TX
  • NPI 1881752715
  Medicare reassignment NPD

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1932069325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 747",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751600014",
            "telephone_number": "972-388-2000",
            "fax_number": "972-524-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 STUART ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015759",
            "telephone_number": "903-455-3987",
            "fax_number": "903-455-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERFORD",
        "first_name": "KINDELL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "109090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquita Walker, PMHNP-BC, FNP-C
• Eric Wang, DDS
• Gregory Scott Ward, FNP, AGACNP
• Michael David Weaks, D.DS
• Ronald David Weaks, D.D.S.
• Kevin S Weatherly, PH.D.
• Amy Weems, LPC
• Brent S. Wehner, D.D.S.
• Jessica Weido, DO
• Wellgen Health System Inc

• Clinical Social Worker in Greenville, TX
• Providers in Greenville, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.