Provider Demographics
NPI:1699593400
Name:KENION, ACACIA JOHNEE (MSW, LCSW-A)
Entity type:Individual
Prefix:
First Name:ACACIA
Middle Name:JOHNEE
Last Name:KENION
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 SOUTHTOWN CIR
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9593
Mailing Address - Country:US
Mailing Address - Phone:919-435-1185
Mailing Address - Fax:
Practice Address - Street 1:105 E CENTER ST STE 105A2
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-2420
Practice Address - Country:US
Practice Address - Phone:910-465-1887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0211601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical