Active NPI
Kendra Mina, LCSW
- Social Worker
- Chattanooga, TN
National Provider Identifier
1962283770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9132
- Practice address
- 3309 Cummings Hwy Ste 110
Chattanooga, TN 37419-2438 - Phone
- (423) 521-2735
- NPI assigned
- Oct 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9132 | TN | |
| Social Worker | 104100000X | 9132 | TN | Primary |
Addresses
Primary practice location
3309 Cummings Hwy Ste 110
Chattanooga, TN 37419-2438
Mailing address
5555 Hixson Pike Apt 207
Hixson, TN 37343-3202
Phone (423) 521-2735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9132 | TN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River City Counseling PC | Single Specialty | Past | Accepting new patients |
Interoperability endpoints
- kendra.mina@489656322949124.direct.elationemr.com
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1962283770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 HIXSON PIKE APT 207",
"city": "HIXSON",
"state": "TN",
"postal_code": "373433202",
"telephone_number": "423-521-2735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3309 CUMMINGS HWY STE 110",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374192438",
"telephone_number": "423-521-2735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINA",
"first_name": "KENDRA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-09",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "9132",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "TN",
"license": "9132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.