Kennemer & Smith Psychological Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

KENNEMER & SMITH PSYCHOLOGICAL SERVICES LLC

Practice address

619 Madison St Ste 108
Oregon City, OR 97045-2354

Phone

(503) 303-4257

Fax

(503) 387-3957

NPI assigned

Nov 11, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Alene Cerasuolo

Title

Office Administrator

Phone

(503) 303-4257

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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

• Kordell Noltan Kennemer, PSYD

  • Clinical Psychologist
  • Oregon City, OR
  • NPI 1730282138
  NPD

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1962004358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 MADISON ST STE 108",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452354",
            "telephone_number": "503-303-4257",
            "fax_number": "503-387-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 MADISON ST STE 108",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452354",
            "telephone_number": "503-303-4257",
            "fax_number": "503-387-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEMER & SMITH PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "CERASUOLO",
        "authorized_official_first_name": "ALENE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "503-303-4257",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500602612",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Office@wfneuropsychology.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "address_1": "619 Madison St Ste 108",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970452354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffery Kempel, LPC
• Sophie Kendall
• Sarah Kendrick, PHD
• Jillian Kennedy, CSWA
• Patricia Kennedy
• Kordell Noltan Kennemer, PSYD
• Allen B Kerr, DMD
• Bethany McGinley Kerr, OTR/L
• John Oliver Kerr
• Taylor Jane Kerr, OD

• Clinical Psychologist in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.