Provider Demographics
NPI:1639404445
Name:KENNY, JORDANA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JORDANA
Middle Name:
Last Name:KENNY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 STILLWELL AVE
Mailing Address - Street 2:ARTICLE 16 CLINIC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4250
Mailing Address - Country:US
Mailing Address - Phone:718-947-3200
Mailing Address - Fax:718-947-3285
Practice Address - Street 1:2214 STILLWELL AVE
Practice Address - Street 2:ARTICLE 16 CLINIC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4250
Practice Address - Country:US
Practice Address - Phone:718-947-3200
Practice Address - Fax:718-947-3285
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074100-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical