DR. KENDRA ANN WOODWORTH PSYD, LP
NPI 1164966560
Psychologist - Clinical in Golden Valley, MN

Active since December 05, 2016Opted out of Medicare · through Aug 20, 2027
1405 LILAC DR N, SUITE 200, GOLDEN VALLEY, MN 55422(763) 545-7708(763) 545-3479 Get Directions Write a Review

NPPES record last updated: December 5, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kendra Ann Woodworth Psyd, Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENDRA ANN WOODWORTH PSYD, LP (NPI 1164966560) is an individual clinical provider in Golden Valley, Minnesota, licensed in Minnesota (LP6072) and active in the NPI registry since December 2016. She has opted out of Medicare through August 20, 2027.

NPPES Registry Identity

NPI1164966560
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KENDRA ANN WOODWORTHCredential: PSYD, LP
Location Address1405 LILAC DR N, SUITE 200Golden Valley, MN 55422-4535
Mailing Address1405 Lilac Dr N, Suite 200Golden Valley, MN 55422-4535 · (763) 545-7708 · Fax (763) 545-3479
Fax(763) 545-3479
Sole ProprietorNo
Enumeration DateDecember 5, 2016
NPI 1164966560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in MN · LP6072
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1405 LILAC DR N, Golden Valley, MN 55422

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Kendra Ann Woodworth Psyd, Lp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 20, 2023 through August 20, 2027.

Opt-Out Effective DateAugust 20, 2023
Opt-Out In Effect ThroughAugust 20, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55422 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$168.28 typical visit price
range $56.00 – $168.28
Typical copayment $42.07 (range $14.00 – $42.07)
Most-billed visit code 99205
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
1405 LILAC DR N
GOLDEN VALLEY, MN 55422
Psychologist (Clinical Child & Adolescent)
1405 LILAC DR N
GOLDEN VALLEY, MN 55422
Counselor (Mental Health)
1405 LILAC DR N, SUITE 151
GOLDEN VALLEY, MN 55422
Social Worker (Clinical)
1405 LILAC DR N
GOLDEN VALLEY, MN 55422
Home Health
1405 LILAC DR N
GOLDEN VALLEY, MN 55422
Psychiatry & Neurology (Psychiatry)
1405 LILAC DR N, STE 150
GOLDEN VALLEY, MN 55422
Clinic/Center (Adult Mental Health)
1405 LILAC DR N
GOLDEN VALLEY, MN 55422
Social Worker (Clinical)
1405 LILAC DR N, SUITE 151
GOLDEN VALLEY, MN 55422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendra Woodworth's NPI number?

The NPI number for Kendra Woodworth is 1164966560. It was assigned to this individual provider in the NPPES registry on December 5, 2016.

Where is Kendra Woodworth located?

Kendra Woodworth practices at 1405 Lilac Dr N Suite 200, Golden Valley, MN 55422. The listed phone number is (763) 545-7708.

What is Kendra Woodworth's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Kendra Woodworth enrolled in Medicare?

No. Kendra Woodworth has opted out of Medicare through August 20, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kendra Woodworth was last updated on December 5, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.