Individual provider Active NPI

Lindsay L Kenyon, LISW

  • Clinical Social Worker
  • Iowa City, IA
National Provider Identifier
1053964098
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007504 Issued in IA
Practice address
3330 Lower West Branch Rd
Iowa City, IA 52245-4102
Phone
(888) 948-6789
Fax
(877) 345-3501
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007504 IA Primary

Addresses

Primary practice location

3330 Lower West Branch Rd
Iowa City, IA 52245-4102

Mailing address

1 Kalisa Way Ste 101
Paramus, NJ 07652-3508
Phone (888) 948-6789

Other names 1

  • Lindsay Klinkefus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007504IAMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1053964098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY STE 101",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523508",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 LOWER WEST BRANCH RD",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522454102",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "LINDSAY",
        "middle_name": "L",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "KLINKEFUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.