Katie Jayne Benton Kenney, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10568 Issued in OR

Practice address

2726 NE Diamond Lake Blvd
Roseburg, OR 97470-3649

Phone

(541) 236-2236

Fax

(866) 499-5715

NPI assigned

Mar 5, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1548534894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1273",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700308",
            "telephone_number": "541-236-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 NE DIAMOND LAKE BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703649",
            "telephone_number": "541-236-2236",
            "fax_number": "866-499-5715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 W Madrone",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974703030",
            "country_code": "US",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1652 NW Hughwood Ct",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974718844",
            "country_code": "US",
            "telephone_number": "541-673-3985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "KATIE",
        "middle_name": "JAYNE BENTON",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A5202",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10568",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670891",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ky'an Kelly
• Francesca Ann Kenfield, QMHA
• Candice Hoke Kennedy, PH.D.
• Lexi Kennedy, CSWA
• Roger Kennedy
• Cynthia Dawn Kent
• Nathaniel Keplinger, DPM
• Pamela D Kerbo
• Deanna Elyse Kercher, RDH
• Olivia Kerr

• Clinical Social Worker in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.