Provider Demographics
NPI:1942353966
Name:WOOLLEY, KENDRA E (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:E
Last Name:WOOLLEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12410 MILESTONE CENTER DR STE 600
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-7102
Mailing Address - Country:US
Mailing Address - Phone:240-499-2839
Mailing Address - Fax:
Practice Address - Street 1:12410 MILESTONE CENTER DR STE 600
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7102
Practice Address - Country:US
Practice Address - Phone:240-499-2839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical