Gary C Kennett, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115687 Issued in MA

Practice address

97 Forest Park Ave
Springfield, MA 01108

Phone

(413) 654-7204

Fax

(413) 747-2655

NPI assigned

Jul 16, 2009

Sex

Male

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: No
• 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

State licenses

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1336379965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 FOREST PARK AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011081631",
            "telephone_number": "413-739-0882",
            "fax_number": "413-781-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 FOREST PARK AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01108",
            "telephone_number": "413-654-7204",
            "fax_number": "413-747-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNETT",
        "first_name": "GARY",
        "middle_name": "C",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geraldine Kennedy, MS RN FNP-BC
• John William Kennedy Jr., MD
• Zil Kennedy
• Maria Elizabeth Kenner, MD
• Cynthia Lucille Kennett-Robbins
• Jessica E Kenney Askew, BS
• Diana Mary Kenney, DPT
• Kens Eyewear Inc.
• Adam Kentish
• Mark Abbott Kenton, DO

• Clinical Social Worker in Springfield, MA
• Providers in Springfield, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.