MICHELLE B KENNEDY (NPI# 1578040754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578040754 |
| Entity Type | Individual |
| Full Name | MICHELLE B KENNEDY |
| Credential | CRM |
| Practice Address |
200 Se Hailey Ave Ste 204 Pendleton OR 97801-3072 |
| Mailing Address |
1101 I Ave La Grande OR 97850-2043 |
| Practice Telephone | 5416634104 |
| Mailing Telephone | 5419620162 |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 16-CRM-012 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508303066 | Michelle Kennedy | Registered Nurse | 4501 Parkwood Dr, Kokomo, IN 46901-6430 | 2017-01-23 |
| 1528459021 | Michelle Elizabeth Kennedy | Nurse Anesthetist, Certified Registered | 2416 Couch St, Houston, TX 77008-1632 | 2015-02-05 |
| 1932501434 | Michelle Kennedy | Licensed Practical Nurse | 10827 Ravenna Rd, 103, Twinsburg, OH 44087-2725 | 2014-09-16 |
| 1811103062 | Michelle Kathleen Kennedy | Marriage & Family Therapist | 2251 Grant Road, Suite H, Los Altos, CA 94024-6958 | 2007-05-15 |
| 1891836110 | Michelle Lynn Kennedy | Nurse Practitioner | 51 N Elm St, Waterbury, CT 06702-1511 | 2007-02-09 |
| 1801821368 | Michelle Kennedy | Social Worker | 5 W 86th St, Suite 1a, New York, NY 10024-3603 | 2006-07-12 |
| 1528670445 | Michelle Ann Kennedy | Behavior Technician | 225 Cedar Hill St Ste 200, Marlborough, MA 01752-5900 | 2020-08-21 |
| 1992210744 | Michelle Kennedy | Counselor | 20 Hartford St, Newton Highlands, MA 02461-1517 | 2017-12-01 |
| 1982062857 | Michelle L Kennedy | Nurse Practitioner | 6140 W Curtisian Ave, Ste 200, Boise, ID 83704 | 2016-02-05 |
| 1114367513 | Michelle Ann Kennedy | Occupational Therapy Assistant | 1020 N Union St, Middletown, PA 17057-2158 | 2013-06-28 |
| Street Address |
200 SE HAILEY AVE STE 204 |
| City | PENDLETON |
| State | OR |
| Zip Code | 97801-3072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023625159 | Amie Loraine Martin | Peer Specialist | 200 Se Hailey Ave Ste 204, Pendleton, OR 97801-3072 | 2020-09-23 |
| 1649889288 | Joanita Glavel Williamson | Counselor | 200 Se Hailey Ave Ste 204, Pendleton, OR 97801-3072 | 2020-07-29 |
| 1316503113 | Stephanie Miller | Social Worker | 200 Se Hailey Ave Ste 204, Pendleton, OR 97801-3072 | 2019-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720637119 | Yvonne Walker | Technician | 821 Se 9th St, Pendleton, OR 97801 | 2019-09-09 |
| 1083262703 | Praxis Medical Group Inc | Family Medicine | 2450 Sw Perkins Avenue, Pendleton, OR 97801 | 2019-08-27 |
| 1255826012 | Cosmas Chukwuemeka Nwerem Jr. | Pharmacist | 1900 Sw Court Place, Pendleton, OR 97801 | 2018-06-25 |
| 1689166811 | Helene Danielle Kuhn | Counselor | 4700 Nw Pioneer Pl, Pendleton, OR 97801 | 2018-06-04 |
| 1801302849 | Shawna L. All | Massage Therapist | 24 Se Emigrant Ave., Pendleton, OR 97801 | 2017-12-27 |
| 1033649256 | Sean Collins | Pharmacist | 203 Sw 20th St, Pendleton, OR 97801 | 2017-06-20 |
| 1073974796 | Channon M Baker | Peer Specialist | 7525 Westgate Bldg #2, Pendleton Creek Crisis Stabilization Unit, Pendleton, OR 97801 | 2016-03-08 |
| 1689034357 | Carre Biegel | Counselor | 17 Sw Frazer St, Ste 282, Pendleton, OR 97801 | 2016-02-24 |
| 1073995429 | Jessica Suzanne Pedersen | Massage Therapist | 812 Nw 12th St, Pendleton, OR 97801 | 2015-06-22 |
| 1861736373 | Christina Northern Northerhn | Social Worker | 331 Se 2nd Street, Pendleton, OR 97801 | 2012-11-21 |
| Find all providers in zip 97801 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124681754 | Seth Jokinen | Peer Specialist | 200 Se Hailey Ave Ste 217, Pendleton, OR 97801-3072 | 2019-04-18 |
| 1073974796 | Channon M Baker | Peer Specialist | 7525 Westgate Bldg #2, Pendleton Creek Crisis Stabilization Unit, Pendleton, OR 97801 | 2016-03-08 |
| 1023625159 | Amie Loraine Martin | Peer Specialist | 200 Se Hailey Ave Ste 204, Pendleton, OR 97801-3072 | 2020-09-23 |
| 1689288227 | Kolin M Craig | Peer Specialist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-09-01 |
| 1578176095 | William Daniel Bernard | Peer Specialist | 715 Sw Dorion Ave, Pendleton, OR 97801-2070 | 2020-08-25 |
| 1003428095 | Mariah Shaunika Ray Wright | Peer Specialist | 715 Sw Dorion Ave, Pendleton, OR 97801-2070 | 2020-08-20 |
| 1952913923 | Jessica Denice Pankey | Peer Specialist | 715 Sw Dorion Ave, Pendleton, OR 97801-2070 | 2020-08-20 |
| 1194351817 | Roxanna J Barnes | Peer Specialist | 17 Sw Frazer Ave Ste 282, Pendleton, OR 97801-0048 | 2020-03-13 |
| 1144867458 | June S Hills | Peer Specialist | 17 Sw Frazer Ave Ste 282, Pendleton, OR 97801-0048 | 2019-12-05 |
| 1518511088 | Laurie Galindo | Peer Specialist | 331 Se 2nd St, Pendleton, OR 97801-2224 | 2019-08-01 |
| Find all providers in PENDLETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.