Active NPI
Kennesse Dew
- Social Worker
- Bristol, FL
National Provider Identifier
1306496229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW13452
- Practice address
- 10611 NW Sr 20
Bristol, FL 32321 - Phone
- (850) 643-1033
- Fax
- (850) 643-5066
- NPI assigned
- Sep 12, 2019
- Last updated
- Sep 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW13452 | FL | Primary |
Addresses
Primary practice location
10611 NW Sr 20
Bristol, FL 32321
Mailing address
6314 Birchwood Rd
Marianna, FL 32448-5202
Phone (850) 272-5764
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
| License | State | Type | Specialty |
|---|---|---|---|
| ISW13452 | FL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568246400000",
"number": "1306496229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6314 BIRCHWOOD RD",
"city": "MARIANNA",
"state": "FL",
"postal_code": "324485202",
"telephone_number": "850-272-5764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10611 NW SR 20",
"city": "BRISTOL",
"state": "FL",
"postal_code": "32321",
"telephone_number": "850-643-1033",
"fax_number": "850-643-5066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEW",
"first_name": "KENNESSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-12",
"last_updated": "2019-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "ISW13452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, FL
- Community Wellness Counseling and Support Services
- Jennifer Conyers
- Alexandra Cook
- County of Liberty Board of County Commissioners (Liberty County Ambulance Service)
- Britt Jeppson Day, MS, CCC-SLP
- Madison Lynn Edwards, MSW
- Demetria Michelle English
- Jennifer Proctor Evans
- Florida Department of Health (Liberty County Health Department)
- Florida Department of Health (Liberty County Health Department)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.