Healthcare Provider Details

I. General information

NPI: 1619706397
Provider Name (Legal Business Name): JOANNA KENNEY SWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 CHAMPA ST
DENVER CO
80205-2529
US

IV. Provider business mailing address

2111 CHAMPA ST
DENVER CO
80205-2529
US

V. Phone/Fax

Practice location:
  • Phone: 303-312-9978
  • Fax:
Mailing address:
  • Phone: 303-312-9978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWC.0000002464
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: