Individual provider Active NPI

Holly A Kendrigan, LCSW

  • Clinical Social Worker
  • Jupiter, FL
National Provider Identifier
1962554337
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5740 Issued in FL
Practice address
4425 Military Trail
Ste. 203
Jupiter, FL 33458-4817
Phone
(561) 747-2775
Fax
(561) 747-1881
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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 SW5740 FL Primary

Addresses

Primary practice location

4425 Military Trail
Ste. 203
Jupiter, FL 33458-4817

Mailing address

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916-9416
Phone (561) 747-2775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20081021000347 FL Practitioner - Clinical Social Worker 0547328585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holly Kendrigan IncGroup PAC ID 0547657769, 2 clinicians

Practice addresses (Care Compare)

125 W Indiantown Rd
Suite 106
Jupiter, FL 33458-3539
Phone (561) 371-2374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW5740FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Kendrigan, Inc. Clinical CurrentSince Apr 1, 2022 Accepting new patients

Locations

125 W Indiantown Rd
Ste 106
Jupiter, FL 33458
Phone (561) 371-2374

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1962554337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY",
            "address_2": "STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "561-747-2775",
            "fax_number": "561-747-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 MILITARY TRAIL",
            "address_2": "STE. 203",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584817",
            "telephone_number": "561-747-2775",
            "fax_number": "561-747-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRIGAN",
        "first_name": "HOLLY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.