Kenyatta B Matthews, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

312 Miller St
Lewiston, ID 83501-1944

Phone

(208) 750-1802

Fax

(208) 750-1803

NPI assigned

Oct 18, 2023

Last updated

Oct 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Riverplace Counseling & Wellness

  • Mental Health Counselor
  • Lewiston, ID
  • NPI 1679085823
  NPD (past)

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1740062231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 MILLER ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011944",
            "telephone_number": "208-750-1802",
            "fax_number": "208-750-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 MILLER ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011944",
            "telephone_number": "208-750-1802",
            "fax_number": "208-750-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "KENYATTA",
        "middle_name": "B",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark R Jones Dba Clearwater Counseling
• Mark R Jones Dba Clearwater Counseling
• Jason Marketti, PTA
• James Marshall III
• Nathan Brian Martin, PT
• Robert Alan Mayer, PHARMD
• Amanda Marie McGehee, PHARM. D.
• Linda Louise McGrale, LICENSED MASSAGE PRA
• Maree P McHugh, FNP
• Brandon McIntosh, LCSW

• Social Worker in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.