Judith Ellen Kennedy, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110706 Issued in NY

Practice address

17 E Genesee St Ste 1
Auburn, NY 13021-4068

Phone

(315) 253-9795

Fax

(315) 253-3255

NPI assigned

Oct 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cayuga Counseling Services IncGroup PAC ID 5890734537, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cayuga Counseling Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Auburn, NY
  • NPI 1194874610

  NY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1407455686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E GENESEE ST STE 1",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214068",
            "telephone_number": "315-253-9795",
            "fax_number": "315-253-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E GENESEE ST STE 1",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214068",
            "telephone_number": "315-253-9795",
            "fax_number": "315-253-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JUDITH",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "110706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORKER CLINICAL",
            "identifier": "1041C0700X",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxine Corrine Kelley, RN
• Sharon Jo Kellogg, LCSW
• Amy Beth Kelly, LCSW
• Brenda Kelly
• Brian J Kelly, PH.D.
• Shelyagh Kennedy, RN,BSN,FPMHNP-BC
• Taylor Renae Kerr, RD, CDN
• Lisa M Kessel, N.P.
• Scott Elmer Kilmer, D.C.
• Jessica Lynn Kimball, PHARM. D.

• Clinical Social Worker in Auburn, NY
• Providers in Auburn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.