Individual provider Active NPI

Kendra F Cunha, LCSW

  • Clinical Social Worker
  • Clovis, CA
National Provider Identifier
1932613569
Registry record updated Mar 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
80135 Issued in CA
Practice address
1865 Herndon Ave # K108
Clovis, CA 93611-6163
Phone
(559) 308-4317
NPI assigned
Nov 17, 2017
Last updated
Mar 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104717 CA
Clinical Social Worker 1041C0700X 80135 CA Primary

Addresses

Primary practice location

1865 Herndon Ave # K108
Clovis, CA 93611-6163

Mailing address

1865 Herndon Ave # K108
Clovis, CA 93611-6163
Phone (559) 308-4317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220112001906 CA Practitioner - Clinical Social Worker 6901298488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A Mind Above a Professional Psychology CorporationGroup PAC ID 1759717978, 5 clinicians

Practice addresses (Care Compare)

1300 E Shaw Ave
Suite 109
Fresno, CA 93710-7903
Phone (559) 712-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104717CAMDClinical Social Worker
80135CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
A Mind Above, a Professional Psychology Corporation CurrentSince Oct 20, 2021 Accepting new patients

Locations

334 Shaw Ave
Ste 100
Clovis, CA 93612
Phone (559) 712-8500

Organizations & group practices 1

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": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679788800000",
    "number": "1932613569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 HERNDON AVE # K108",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116163",
            "telephone_number": "559-308-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 HERNDON AVE # K108",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116163",
            "telephone_number": "559-308-4317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNHA",
        "first_name": "KENDRA",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2023-03-26",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104717",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.