MEDICARE: DR. KENDALL L. MOODY PHD, 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	0904009833	VA

General Provider Information

NPI Number	:	1790213262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENDALL L. MOODY PHD, LCSW

Provider Business Mailing Address
First Line	:	1992 BIZZONE CIR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-1538
Country	:	US
Telephone Number	:	757-647-5695
Fax Number	:

Provider Business Practice Location Address
First Line	:	2249 RUBY TURN
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-1897
Country	:	US
Telephone Number	:	757-647-5695
Fax Number	:

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

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	08/14/2025

Similar Medicare Providers

1588146971 — OLUWASOLA TALE CNA
Practice Location Address:

2262 RUBY TURN
BOWIE, MD
20721-1897

Practice Phone: 240-696-9987
Practice Fax:

1710711635 — AZEEZAT OLORUNOJE
Practice Location Address:

2261 RUBY TURN
BOWIE, MD
20721-1897

Practice Phone: 615-779-2946
Practice Fax:

1346137510 — OLUROTIMI SAMUEL FOWOWE
Practice Location Address:

2262 RUBY TURN
MITCHELLVILLE, MD
20721-1897

Practice Phone: 240-713-9740
Practice Fax:

1013879899 — TOP CHOICE HEALTHCARE LLC
Practice Location Address:

2600 BALLSTON CT
BOWIE, MD
20721-3281

Practice Phone: 301-256-1546
Practice Fax:

1629764832 — KONTEMPO HEALTHCARE
Practice Location Address:

804 CYPRESS POINT CIR
BOWIE, MD
20721-2302

Practice Phone: 301-661-7268
Practice Fax: 301-724-4898

1174488308 — A TO X CLINICAL CONSULTING, LLC
Practice Location Address:

1207 STOCKPORT CT
BOWIE, MD
20721-1836

Practice Phone: 240-509-0083
Practice Fax:

Directions to “ DR. KENDALL L. MOODY PHD, LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.