Active NPI
Kendra Kearney, MSW
- Clinical Social Worker
- Traverse City, MI
National Provider Identifier
1700608429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6851115545
- Practice address
- 4230 Copper Ridge Dr
Traverse City, MI 49684-7256 - Phone
- (231) 935-6382
- NPI assigned
- Oct 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 6851115545 | MI | Primary |
Addresses
Primary practice location
4230 Copper Ridge Dr
Traverse City, MI 49684-7256
Mailing address
PO Box 1654
Acme, MI 49610-1654
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6851115545 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1700608429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1654",
"city": "ACME",
"state": "MI",
"postal_code": "496101654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 COPPER RIDGE DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847256",
"telephone_number": "231-935-6382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEARNEY",
"first_name": "KENDRA",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-25",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6851115545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.