Emily Keniston, LICSW

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

Practice address

64 Industrial Park Rd
Suite 5
Plymouth, MA 02360-4881

Phone

(617) 847-1950

Fax

(617) 774-1490

NPI assigned

Dec 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MA

  Medicare reassignment NPD

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1134664352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 INDUSTRIAL PARK RD",
            "address_2": "SUITE 5",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604881",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 INDUSTRIAL PARK RD",
            "address_2": "SUITE 5",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604881",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENISTON",
        "first_name": "EMILY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-23",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Elizabeth Kelly
• David Kelly, MD
• Melissa Rose Kelly, LICSW
• Lori Ann Kenchik-Peterson, PMHNP-BC
• Norman Kendall, MSW
• Juli Kennedy-Killion, MS
• Jazmin Marie Kennedy
• Jeremy Kennedy
• Karen Kennedy
• Kristin S. Kenney, O.D.

• Health Service Psychologist in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Health Service Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.