Individual provider Active NPI

Judith Arlene McKenna, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1699765263
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R038905-1 Issued in NY
Practice address
105 Sullivan St
Apartment 3a
New York, NY 10012-3669
Phone
(212) 965-0151
NPI assigned
Oct 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R038905-1 NY Primary

Addresses

Primary practice location

105 Sullivan St
Apartment 3a
New York, NY 10012-3669

Mailing address

105 Sullivan St
Apartment 3a
New York, NY 10012-3669
Phone (212) 965-0151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R038905-1NYMDClinical Social Worker
038905NYMDOral and Maxillofacial Surgery (Dentist)
038095NYMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1699765263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SULLIVAN ST",
            "address_2": "APARTMENT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123669",
            "telephone_number": "212-965-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SULLIVAN ST",
            "address_2": "APARTMENT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123669",
            "telephone_number": "212-965-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JUDITH",
        "middle_name": "ARLENE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R038905-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.