Provider Demographics
NPI:1306060884
Name:KENNEY, MARGARET (LISW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:KENNEY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 641130
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7130
Mailing Address - Country:US
Mailing Address - Phone:402-572-2907
Mailing Address - Fax:402-572-3544
Practice Address - Street 1:801 HARMONY ST
Practice Address - Street 2:SUITE 302
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-3106
Practice Address - Country:US
Practice Address - Phone:712-328-2609
Practice Address - Fax:712-328-9257
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI12777Medicare PIN