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Individual
SAMANTHA JEAN KENNEY
Active
Individual
SAMANTHA JEAN KENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
17350
MD
1041C0700X
Clinical Social Worker
Primary
17350
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
346646
MHN/TRICARE
MD
01
—
517251
OPTUM
MD
01
—
522156095
COMMERCIAL INS
MD
05
—
609550001
—
MD
05
—
609550004
—
MD
01
—
7840093
AETNA
MD
01
—
LM49EA
CAREFIRST LOCAL
MD
01
—
R968
CAREFIRST HMO
MD
Enumeration date
08/24/2011
Last updated
09/14/2015
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