Individual provider Active NPI

Michael C Kenney, ACSW, LCSW

  • Mental Health Counselor
  • Phillipsburg, NJ
National Provider Identifier
1679650204
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC01440000 Issued in NJ
Practice address
305 Roseberry St
Suite 8
Phillipsburg, NJ 08865-1600
Phone
(908) 454-7244
Fax
(908) 859-2109
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SC01440000 NJ Primary

Addresses

Primary practice location

305 Roseberry St
Suite 8
Phillipsburg, NJ 08865-1600

Mailing address

158 Parker Ave
Easton, PA 18042-1300
Phone (610) 258-9433

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131217001141 NJ Practitioner - Clinical Social Worker 5698902781 Practice locations: Phillipsburg, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

114 S 2ND St
Phillipsburg, NJ 08865-1806
Phone (610) 248-2559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
44SC01440000NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Psych. Care Incoporated PastSince Nov 6, 2007 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679650204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 PARKER AVE",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180421300",
            "telephone_number": "610-258-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ROSEBERRY ST",
            "address_2": "SUITE 8",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651600",
            "telephone_number": "908-454-7244",
            "fax_number": "908-859-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "ACSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC01440000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

Verify at the official NPI Registry.