Kenney, Katie Jayne Benton

Kenney, Katie Jayne Benton is an individual health care provider with primary practice located at 2726 Ne Diamond Lake Blvd , Roseburg OR 97470-3649. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kenney, Katie Jayne Benton can be contacted via phone (541) 236-2236.

Contact Information

Primary practice address
2726 Ne Diamond Lake Blvd Roseburg OR 97470-3649
Phone: (541) 236-2236
Fax: (866) 499-5715
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X A5202 Oregon
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X L10568 Oregon
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1548534894
LBN Legal business name Kenney, Katie Jayne Benton
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2012
Last updated Feb 1st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548534894 NPPES
Oregon MEDICAID 500670891

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