Jessica Brooke Kenworthy, MS CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

ST2905 Issued in ME

Practice address

125 Presumpscot St Unit 10
Portland, ME 04103-5225

Phone

(207) 747-5394

NPI assigned

Apr 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jessica Rachel Kenworthy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1326501495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 SPRUCE ST APT 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041024068",
            "telephone_number": "617-710-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PRESUMPSCOT ST UNIT 10",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035225",
            "telephone_number": "207-747-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENWORTHY",
        "first_name": "JESSICA",
        "middle_name": "BROOKE",
        "credential": "MS CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST2905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MAINE- TEMPORARY SPEECH LANGUAGE PATHOLOGIST",
            "identifier": "ST2905",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KENWORTHY",
            "middle_name": "RACHEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julianna Cole Kenney, P.A.
• Patricia A Kenney, RPH, MHA
• Gina M Kenny, PHD
• Alison L Kent, CRNA
• Melanie Kent, CRNA
• Brendan Michael Kenyon, MD
• Michael Keogh, DPT
• Alexandra Sofia Keokosky
• Kristien Keown
• James Kerney III, DO

• Speech-Language Pathologist in Portland, ME
• Providers in Portland, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.

Verify at the official NPI Registry.