Individual provider Active NPI

Kenisha Bakayoko

  • Clinical Social Worker
  • West Orange, NJ
National Provider Identifier
1093311375
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05929000 Issued in NJ
Practice address
500 Prospect Ave Ste 300
West Orange, NJ 07052-4165
Phone
(862) 505-9191
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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 44SC05929000 NJ Primary

Addresses

Primary practice location

500 Prospect Ave Ste 300
West Orange, NJ 07052-4165

Mailing address

500 Prospect Ave Ste 300
West Orange, NJ 07052-4165

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
44SC05929000NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Counseling Services LLC Clinical Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1093311375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PROSPECT AVE STE 300",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PROSPECT AVE STE 300",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524165",
            "telephone_number": "862-505-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKAYOKO",
        "first_name": "KENISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05929000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.