Provider Demographics
NPI:1417470964
Name:CARPENTER, KENSEENER (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KENSEENER
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KENSEENER
Other - Middle Name:
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:153 E 165TH ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-9142
Mailing Address - Country:US
Mailing Address - Phone:347-431-2864
Mailing Address - Fax:
Practice Address - Street 1:1650 SELWYN AVE APT 6D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7688
Practice Address - Country:US
Practice Address - Phone:718-960-4472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker