Angela A Kenedy, LIMHP, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1645 Issued in NE

Practice address

4611 S 96TH St Ste 174
Omaha, NE 68127-1242

Phone

(402) 320-2336

NPI assigned

Jun 29, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

Practice roles

Locations

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.

• Ponca Tribe of Nebraska

  • Clinic/Center
  • Omaha, NE
  • NPI 1710172879

  TX

  Medicare reassignment NPD
• Lavender Road Therapy Services, LLC

  • Adult Mental Health Clinic/Center
  • Omaha, NE
  • NPI 1942130638
  NPD Authorized official
• Ponca Tribe of Nebraska

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Lincoln, NE
  • NPI 1275103103
  NPD (past)

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779494400000",
    "number": "1881958338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 174",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271242",
            "telephone_number": "402-320-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 174",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271242",
            "telephone_number": "402-320-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENEDY",
        "first_name": "ANGELA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LIMHP, LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2026-05-23",
        "certification_date": "2026-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1291",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1645",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ganeva Kendall, MD
• Lauren Elizabeth Kendall, MOT, OTR/L
• Weston Kendall
• Stacy Kendrick
• Connor Edwin Kendzora
• Jay G Kenik, M.D.
• Amy J Kenkel, APRN
• Ashley Mary Kenkel
• Jean C Kenkel, APRN
• John P Kenna, OTR/L

• Clinical Social Worker in Omaha, NE
• Providers in Omaha, NE by specialty
• Clinical Social Worker in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2026; 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.