Active NPI
Kyle Michale Kennedy, LCSW
- Clinical Social Worker
- East Petersburg, PA
National Provider Identifier
1689027880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW027261
- Practice address
- 1987 State St
East Petersburg, PA 17520-1324 - Phone
- (717) 723-8040
- NPI assigned
- Jul 22, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW027261 | PA | Primary |
Addresses
Primary practice location
1987 State St
East Petersburg, PA 17520-1324
Mailing address
1987 State St
East Petersburg, PA 17520-1324
Phone (717) 723-8040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 22, 2026 through Apr 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW027261 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1689027880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1987 STATE ST",
"city": "EAST PETERSBURG",
"state": "PA",
"postal_code": "175201324",
"telephone_number": "717-723-8040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1987 STATE ST",
"city": "EAST PETERSBURG",
"state": "PA",
"postal_code": "175201324",
"telephone_number": "717-723-8040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "KYLE",
"middle_name": "MICHALE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-22",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW027261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Petersburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.