Kathleen Anne Kenny, CNM, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61095962 Issued in WA

Practice address

22722 29TH Dr SE Ste 100
Bothell, WA 98021-4420

Phone

(206) 300-2538

Fax

(206) 649-7098

NPI assigned

Oct 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

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

• Obstetrix Medical Group of Washington Inc PS

  • Maternal & Fetal Medicine Physician
  • Seattle, WA
  • NPI 1861599573
  Medicare reassignment
• Seattle Nuclear Medicine-Ultrasound Associates

  • Radiology Clinic/Center
  • Seattle, WA
  • NPI 1265506349
  NPD (past)

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1831386028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 GREENWOOD AVE N # 218",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034627",
            "telephone_number": "206-300-2538",
            "fax_number": "206-649-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22722 29TH DR SE STE 100",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214420",
            "telephone_number": "206-300-2538",
            "fax_number": "206-649-7098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10634 E Riverside Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980113758",
            "country_code": "US",
            "telephone_number": "206-934-9110",
            "fax_number": "206-649-7098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNY",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "CNM, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP30006613",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61095962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0252114",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831386028",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly White Counseling
• Liam M Kelly, MSW, LISWAIC
• Rosemarie Ann Kennaley, MD
• Catherine Kennedy, M.S., CCC-SLP
• Keri Francis Kennedy
• Ty Dannon Kent, LMP
• Mary K Kerr
• Kimberly Kessler, LMP
• Ketchinae Psychological Services
• Linda Kha, PHARMD.

• Psychiatric/Mental Health Nurse Practitioner in Bothell, WA
• Providers in Bothell, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.