MEDICARE: DR. HUNTER G KENNEDY PSY.D., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	62589	TX

General Provider Information

NPI Number	:	1972649309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUNTER G KENNEDY PSY.D., LPC

Provider Business Mailing Address
First Line	:	1201 LAKE WOODLANDS DR STE 4009
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-5000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 LAKE WOODLANDS DR STE 4009
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-5000
Country	:	US
Telephone Number	:	281-701-9220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	04/02/2024

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