Active NPI
Amanda Marie Kennedy, MSW, LCSW, MS, SLP
- Speech-Language Pathologist
- Newport, OR
National Provider Identifier
1750603320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 016067
- Practice address
- 459 SW Coast Hwy
Newport, OR 97365 - Phone
- (541) 265-9211
- Fax
- (406) 494-1724
- NPI assigned
- Feb 23, 2010
- Last updated
- Feb 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L6713 | OR | |
| Speech-Language Pathologist | 235Z00000X | 016067 | OR | Primary |
Addresses
Primary practice location
459 SW Coast Hwy
Newport, OR 97365
Mailing address
PO Box 1110
Newport, OR 97365
Phone (541) 265-9211
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L6713 | OR | MD | Clinical Social Worker |
| 016067 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518134400000",
"number": "1750603320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1110",
"city": "NEWPORT",
"state": "OR",
"postal_code": "97365",
"telephone_number": "541-265-9211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "459 SW COAST HWY",
"city": "NEWPORT",
"state": "OR",
"postal_code": "97365",
"telephone_number": "541-265-9211",
"fax_number": "406-494-1724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "MSW, LCSW, MS, SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2018-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L6713",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "016067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.