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KENDRA D PHOUMIVONG LMSW
NPI 1336596931
Social Worker - Clinical in Atlanta, GA

Active since May 24, 2016
690 COURTENAY DR NE, ATLANTA, GA 30306(404) 875-4551 Get Directions Write a Review

NPPES record last updated: January 31, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 31, 2023, Apr 2, 2019, Nov 16, 2016 (3 updates tracked since 2016).

About Kendra D Phoumivong Lmsw NPPES

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

KENDRA D PHOUMIVONG LMSW (NPI 1336596931) is an individual clinical provider in Atlanta, Georgia, licensed in Georgia (CSW006876) and active in the NPI registry since May 2016.

NPPES Registry Identity

NPI1336596931
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKENDRA D PHOUMIVONGCredential: LMSW
Location Address690 COURTENAY DR NEAtlanta, GA 30306-3421
Mailing Address5 Summer Lake WaySavannah, GA 31407-3534 · (912) 247-3969
Phone(404) 875-4551
Sole ProprietorNo
Enumeration DateMay 24, 2016
Last NPPES UpdateJanuary 31, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 31, 2023
✔ NPI 1336596931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in GA · CSW006876✔ Licensed in AR · 8033-C
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedSocial WorkerTaxonomy 104100000X · License 8033-M (AR)
690 COURTENAY DR NE, Atlanta, GA 30306
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Other Names 1

Former Name (1)Kendra Butler

Other Providers at the Same Location NPPES 20

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

CAMIRA FERGUSON LPC
Counselor (Professional)
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (404) 875-4551
KATHLEEN LYNN HERZER LMSW
Social Worker
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (404) 875-4551
WILLIAM ROY CHANCEY
Social Worker (Clinical)
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (404) 875-4551
TAYLOR NICOLE WHELCHEL LAPC
Counselor
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (404) 875-4551
CHARLOTTE SUSANN VICK LMSW, MFT
Social Worker
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (770) 241-0123
JUNE COURTNEY DAVIS LMSW
Social Worker (Clinical)
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (404) 875-4551
JASMINE SPRATLING APC
Counselor (Mental Health)
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (404) 875-4551
TAYLOR NICOLE LOGGINS LMSW
Social Worker
690 COURTENAY DR NE
ATLANTA, GA 30306
Fulton County (404) 875-4551

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 Phoumivong's NPI number?

The NPI number for Kendra Phoumivong is 1336596931. It was assigned to this individual provider in the NPPES registry on May 24, 2016. The provider is also known as Kendra Butler.

Where is Kendra Phoumivong located?

Kendra Phoumivong practices at 690 Courtenay Dr NE, Atlanta, GA 30306. The listed phone number is (404) 875-4551.

What is Kendra Phoumivong's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Kendra Phoumivong was last updated on January 31, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.