Individual provider Active NPI

Kenloy Henry

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1174394530
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1276186181 Issued in NY
Practice address
545 Brooklyn Ave Apt 1
Brooklyn, NY 11225-5230
Phone
(347) 461-8083
NPI assigned
Jan 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1276186181 NY Primary

Addresses

Primary practice location

545 Brooklyn Ave Apt 1
Brooklyn, NY 11225-5230

Mailing address

1400 Old Country Rd Ste C103N
Westbury, NY 11590-5156
Phone (516) 806-6969

Other practice location 1

1400 Old Country Rd Ste C103N
Westbury, NY 11590-5156
Phone (516) 806-6969

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1276186181NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Psychological Services PLLC CurrentSince Jan 1, 2024 Accepting new patients
Family of Kidz Specialist PastSince Jan 1, 2024 Accepting new patients

Organizations & group practices 2

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": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1174394530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE C103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905156",
            "telephone_number": "516-806-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BROOKLYN AVE APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112255230",
            "telephone_number": "347-461-8083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Old Country Rd Ste C103N",
            "address_purpose": "LOCATION",
            "city": "Westbury",
            "state": "NY",
            "postal_code": "115905156",
            "country_code": "US",
            "telephone_number": "516-806-6969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KENLOY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1276186181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.