Kenneth Edwards, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RO36605-01 Issued in NY

Practice address

500 Montauk Hwy Ste M
West Islip, NY 11795-4419

Phone

(631) 766-6014

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982796793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MONTAUK HWY STE M",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954419",
            "telephone_number": "631-766-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MONTAUK HWY STE M",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954419",
            "telephone_number": "631-766-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO36605-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Eastman, MD
• Michael Charles Eaton, FNP-C, RN, CNOR
• Ira Eckstein, DO
• Edward H. Cussatti,M.D., P.C.,LLC
• Edward M. Timmins, D.O., P.C.
• Susan Egner-Whalen, PA
• Kathleen Veronica Ehlers, PA-C
• Paula Eicher, LCSW
• Elliott Eisenberger, MD
• Naomi Eisner, MS, CGC

• Clinical Social Worker in West Islip, NY
• Providers in West Islip, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.