Kendra Blue, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12695 Issued in MD

Practice address

8240 Professional PL Ste 200
Landover, MD 20785-2215

Phone

(301) 577-4440

Fax

(301) 577-4123

NPI assigned

Nov 29, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Essential Therapeutic Perspectives, Inc

  • Community/Behavioral Health Agency
  • Landover, MD
  • NPI 1174713358
  NPD
• Essential Therapeutic Perspectives, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Landover, MD
  • NPI 1881894525
  NPD

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1972073179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8240 PROFESSIONAL PL STE 200",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207852215",
            "telephone_number": "301-577-4440",
            "fax_number": "301-577-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 PROFESSIONAL PL STE 200",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207852215",
            "telephone_number": "301-577-4440",
            "fax_number": "301-577-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "KENDRA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keyonna Latarsha Berry, LGSW
• La-Vora Better
• Brenard Blackmon
• Martina Blake
• Blossom 24HR Home Care LLC
• Akua Odi Boateng, MS RDN LD
• Pauline Boldin, LCSW-C
• Max Bolston, COTA
• Jose Francisco Bonangelino, LMSW
• Olga Borissow

• All providers in Landover, MD
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.