MR. SHANE D KENNINGTON LCSW
NPI 1174754493
Social Worker - Clinical in Portland, OR

Active since August 04, 2009PECOS EnrolledAccepts Medicare Assignment
1750 SW SKYLINE BLVD STE 206, PORTLAND, OR 97221(503) 327-5584(971) 351-6851 Get Directions Write a Review

NPPES record last updated: October 13, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 13, 2023, Sep 20, 2016, Sep 13, 2016 (3 updates tracked since 2016).

About Mr. Shane D Kennington Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SHANE D KENNINGTON LCSW (NPI 1174754493) is an individual clinical provider in Portland, Oregon, licensed in Oregon (L7078) and active in the NPI registry since August 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1174754493
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. SHANE D KENNINGTONCredential: LCSW
Location Address1750 SW SKYLINE BLVD STE 206Portland, OR 97221-2545
Mailing Address1750 Sw Skyline Blvd Ste 206Portland, OR 97221-2545 · (503) 327-5584 · Fax (971) 351-6851
Fax(971) 351-6851
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateAugust 4, 2009
Last NPPES UpdateOctober 13, 20233 updates tracked since enumeration
NPPES CertifiedOctober 13, 2023
NPI 1174754493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in OR · L7078
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

1750 SW SKYLINE BLVD STE 206, Portland, OR 97221

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Shane D Kennington Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527195858
PECOS Enrollment IDI20161005002186
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97221 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $58.99 – $176.88
Typical copayment $0.00 (range $14.74 – $44.22)
Most-billed visit code NA
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Kennington's NPI number?

The NPI number for Shane Kennington is 1174754493. It was assigned to this individual provider in the NPPES registry on August 4, 2009.

Where is Shane Kennington located?

Shane Kennington practices at 1750 SW Skyline Blvd Ste 206, Portland, OR 97221. The listed phone number is (503) 327-5584.

What is Shane Kennington's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shane Kennington enrolled in Medicare?

Yes. Shane Kennington is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shane Kennington accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Shane Kennington as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shane Kennington was last updated on October 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.