MEDICARE: MRS. KENDALL KAY PASSMORE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.027394	IL

General Provider Information

NPI Number	:	1588495311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KENDALL KAY PASSMORE LCSW

Provider Business Mailing Address
First Line	:	1005 BROADWAY ST
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62301-2834
Country	:	US
Telephone Number	:	217-223-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	927 BROADWAY ST
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62301-2719
Country	:	US
Telephone Number	:	217-223-1200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2024
Last Update Date	:	06/09/2026

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