Jennifer Kotley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L8432 Issued in OR

Practice address

2154 SW 8TH Dr
Gresham, OR 97080-6514

Phone

(956) 279-4982

NPI assigned

Jul 20, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1619454816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 SW 8TH DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 SW 8TH DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806514",
            "telephone_number": "956-279-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLEY",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Kokhanevych
• Audrey Jean Kolb, L.M.T.
• Elizabeth Kornegay, R.PH.
• Illona Kornienko
• Michael A Kostin
• Megan Ryan Kovacich, MS, CCC-SLP
• Robert Joseph Kowal, D.D.S.
• Duane W Kowalski, CRM/PSS
• Sara A Koyano, QMHP-C, CADC-I
• Linda Mary Krausse, PT

• Clinical Social Worker in Gresham, OR
• Providers in Gresham, 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 Jun 23, 2022; 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.