Jennifer D Kennedy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12587 Issued in FL

Practice address

5515 1St Ave E Apt 208
Bradenton, FL 34208-6130

Phone

(815) 343-6791

NPI assigned

Mar 10, 2022

Sex

Female

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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Coastal Mental Health & Wellness, LLC

  • Clinical Social Worker
  • Lakewood Ranch, FL
  • NPI 1679082978
  Medicare reassignment

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1497402390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 1ST AVE E APT 208",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342086130",
            "telephone_number": "815-343-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 1ST AVE E APT 208",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342086130",
            "telephone_number": "815-343-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole R Kemper, LAT, ATC
• Cayla Rae Kendzior, PA-C
• Kennedy Pain Clinic Group LLC
• Aaron D Kennedy, DMD
• Gianna Kennedy
• Joey Thomas Kenney, MD
• Chasity Kentros
• Alison Kerr-White, LPN
• Peggy Kerr, PERM MAKEUP ARTIST
• Kylee Anne Kessler, DC

• Clinical Social Worker in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.