Darelivethrive, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DARELIVETHRIVE, LLC

Practice address

4730 SW Macadam Ave
Suite 201-G
Portland, OR 97239-6417

Phone

(818) 370-6423

NPI assigned

Sep 13, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Shane D Kennington, MSWNPI 1174754493

Title

Owner

Phone

(818) 370-6423

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shane D Kennington, LCSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1174754493
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1861940306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 SW MACADAM AVE",
            "address_2": "SUITE 201-G",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396417",
            "telephone_number": "818-370-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 SW MACADAM AVE",
            "address_2": "SUITE 201-G",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396417",
            "telephone_number": "818-370-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARELIVETHRIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "KENNINGTON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-370-6423",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Darby
• Stacy L Darby, LMT
• Deann Dardis, RDH
• Steven Francis Dardis, LAC
• Jon E Dare, LMP, LMT
• Jay Darien, BA, MA
• Mary Jane Darin, M.S., CCC-SLP
• Andrea Darke
• Laurel Ann Darkins, FNP-BC
• Martha Lyle Darkins, LPC,RN

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.