Active NPI
Charles Andrew Kennedy, ASW
- Social Worker
- Guerneville, CA
National Provider Identifier
1336856210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 109436
- Practice address
- 16387 First Street
Guerneville, CA 95446-9544 - Phone
- (707) 326-1452
- NPI assigned
- Nov 1, 2022
- Sex
- Male
- 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 | 109436 | CA | Primary |
Addresses
Primary practice location
16387 First Street
Guerneville, CA 95446-9544
Mailing address
PO Box 1449
Guerneville, CA 95446-1449
Phone (707) 326-1425
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.wchealth.org |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West County Health Centers, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Occidental Area Health Center
- Federally Qualified Health Center (FQHC)
- Occidental, CA
- NPI 1598768962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1336856210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1449",
"city": "GUERNEVILLE",
"state": "CA",
"postal_code": "954461449",
"telephone_number": "707-326-1425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16387 FIRST STREET",
"city": "GUERNEVILLE",
"state": "CA",
"postal_code": "954469544",
"telephone_number": "707-326-1452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "CHARLES",
"middle_name": "ANDREW",
"credential": "ASW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-01",
"last_updated": "2022-11-01",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "109436",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.wchealth.org",
"affiliation": "N",
"address_1": "16387 First Street",
"city": "Guerneville",
"state": "CA",
"country_code": "US",
"postal_code": "954469544",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Guerneville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.