Kevin D Ensenat, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

18KT01439200 Issued in NJ

Practice address

94 Valley Rd
Montclair, NJ 07042-2211

Phone

(201) 788-2666

NPI assigned

Jun 19, 2024

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1487498127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 E 7TH ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111712",
            "telephone_number": "201-788-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422211",
            "telephone_number": "201-788-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENSENAT",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT01439200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Massage Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.