Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mollie J Kenerson

Individual provider Case Manager/Care Coordinator · NPI 1164156584

Mollie J Kenerson is a Clinical Social Worker in Fayetteville, Arkansas. Qualified in 2022, 4 years ago. Licensed in Arkansas.

Years since qualifying
4
Licensed in
AR
In the registry since
2022
Specialties on file
2

Practice location Address checks out

60 W Sunbridge Dr
Fayetteville, AR 72703-1822
Phone: (479) 695-1240
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 12123-C (AR)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1164156584
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 12, 2022
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Fayetteville