Ida Rose Kenna, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00281600 Issued in NJ

Practice address

601 Broadway
Bayonne, NJ 07002-3818

Phone

(201) 339-9200

Fax

(201) 339-7842

NPI assigned

Oct 20, 2009

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 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Mental Health Counselor

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Creative Care Psychiatry LLCGroup PAC ID 8022595008, 5 clinicians

Optum Medical Care of New Jersey PCGroup PAC ID 3072650290, 168 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Creative Care Psychiatry LLC

  • Psychiatry Physician
  • North Bergen, NJ
  • NPI 1134080773
  Medicare reassignment Care Compare group NPD
• Optum Medical Care of New Jersey PC

  • Pediatrics Physician
  • New Hyde Park, NY
  • NPI 1578665048

  NJ

  Medicare reassignment Care Compare group NPD
• Creative Care Psychiatry

  • Psychiatry Physician
  • North Bergen, NJ
  • NPI 1912861287
  NPD
• Optum Medical Care of New Jersey PC

  • Durable Medical Equipment & Medical Supplies
  • Belleville, NJ
  • NPI 1255050902
  NPD
• A.G. Dikengil, MD, PA

  • Radiology Clinic/Center
  • Lyndhurst, NJ
  • NPI 1205992690
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1508192907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023818",
            "telephone_number": "201-339-9200",
            "fax_number": "201-339-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023818",
            "telephone_number": "201-339-9200",
            "fax_number": "201-339-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNA",
        "first_name": "IDA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00281600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021806",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayros Transportation, Inc.
• Aryeh Y Keehn, M,D
• Keith Gurland, M.D.
• Shawn Kelly
• Adam Kendler, PSYD
• Amant Kerls
• Eric Kerr, M.D.
• Kessler Institute for Rehabilitation Inc
• Clara Khalel, PHARMD
• Fariah Khalid, MD

• Mental Health Counselor in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.