Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kendon Ellerman

Individual provider Clinical Social Worker · NPI 1104792860

Kendon Ellerman is a Clinical Social Worker in Hattiesburg, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2025

Practice location Address checks out

108 Victoria Dr
Hattiesburg, MS 39402-3439
Phone: (228) 861-8870
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C7432 (MS)

Record details

NPI number1104792860
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 10, 2025
Last updated in NPPESOctober 10, 2025
Certification dateOctober 10, 2025

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