Willow R Kenyon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-37482 Issued in ID

Practice address

427 N 12TH St
Plummer, ID 83851-0388

Phone

(208) 686-1931

Fax

(208) 686-0213

NPI assigned

Oct 23, 2015

Last updated

Apr 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benewah Medical CenterGroup PAC ID 6709878622, 27 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benewah Medical Center

  dba Marimn Health

  • Federally Qualified Health Center (FQHC)
  • Plummer, ID
  • NPI 1336135136
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1982076410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "838510388",
            "telephone_number": "208-686-1931",
            "fax_number": "208-686-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 N 12TH ST",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "838510388",
            "telephone_number": "208-686-1931",
            "fax_number": "208-686-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "WILLOW",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-37482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "37482",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Holland
• Darcy Ann Humphrey, RN
• David Allen Ingebritsen, PHD LCPC
• Caley Jordan, PHARMD
• Ryan Kain, D.C.
• Sharilyn J Kidder, RN
• Tiffany Marie Korrer, PTA
• Cathleen L Laplante, RDH
• Roger D Laplante, MSW
• Tucker Lloyd Larsen, PA-C

• Clinical Social Worker in Plummer, ID
• Providers in Plummer, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.