Active NPI
Nicole K.a. Kennedy, LISW
- Clinical Social Worker
- Athens, OH
National Provider Identifier
1952843252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I1700438
- Practice address
- 141 Columbus Rd
Athens, OH 45701-1315 - Phone
- (740) 249-4318
- Fax
- (740) 249-4330
- NPI assigned
- Nov 17, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I1700438 | OH | Primary |
Addresses
Primary practice location
141 Columbus Rd
Athens, OH 45701-1315
Mailing address
PO Box 188
Chillicothe, OH 45601-0188
Phone (740) 773-4366
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I1700438 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572912000000",
"number": "1952843252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 188",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456010188",
"telephone_number": "740-773-4366",
"fax_number": "740-775-7855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 COLUMBUS RD",
"city": "ATHENS",
"state": "OH",
"postal_code": "457011315",
"telephone_number": "740-249-4318",
"fax_number": "740-249-4330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "NICOLE",
"middle_name": "K.A.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-17",
"last_updated": "2019-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I1700438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.