Healthcare Provider Details

I. General information

NPI: 1184941502
Provider Name (Legal Business Name): DENA ERNESTINE KEMP MSW, CADC, CPS, BHRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2010
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date: 11/22/2017
Reactivation Date: 08/12/2025

III. Provider practice location address

709 W HICKORY AVE
ENID OK
73701-2561
US

IV. Provider business mailing address

709 W HICKORY AVE
ENID OK
73701-2561
US

V. Phone/Fax

Practice location:
  • Phone: 580-541-5521
  • Fax:
Mailing address:
  • Phone: 580-541-5521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21892-P
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: