Active NPI
Sean J Kenny, PH.D.
- Counseling Psychologist
- Grand Rapids, MI
National Provider Identifier
1437165685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301009458
- Practice address
- 233 Fulton St E
Suite 428
Grand Rapids, MI 49503-3200 - Phone
- (616) 752-8381
- NPI assigned
- Jul 31, 2006
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301009458 | MI | Primary |
Addresses
Primary practice location
233 Fulton St E
Suite 428
Grand Rapids, MI 49503-3200
Mailing address
233 Fulton St E
Suite 428
Grand Rapids, MI 49503-3200
Phone (616) 752-8381
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68-0-D1-4643-0 | Other | MI | BLUE CROSS PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050308000607 | MI | Practitioner - Clinical Psychologist | 2466406947 | Practice locations: Grand Rapids, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
233 Fulton E St
Suite 428
Grand Rapids, MI 49503-3261
233 Fulton St E
Suite 428
Grand Rapids, MI 49503-3261
Phone (616) 752-8381
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301009458 | MI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437165685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 FULTON ST E",
"address_2": "SUITE 428",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495033200",
"telephone_number": "616-752-8381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 FULTON ST E",
"address_2": "SUITE 428",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495033200",
"telephone_number": "616-752-8381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNY",
"first_name": "SEAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301009458",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER ID",
"identifier": "68-0-D1-4643-0",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.