Healthcare Provider Details

I. General information

NPI: 1669872347
Provider Name (Legal Business Name): JAMES R. KINNEY JR., PSY.D., P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2014
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 HIGHWOOD CT
DUNEDIN FL
34698-6318
US

IV. Provider business mailing address

2410 NORTHSIDE DR
CLEARWATER FL
33761-2236
US

V. Phone/Fax

Practice location:
  • Phone: 727-463-2843
  • Fax: 727-784-1890
Mailing address:
  • Phone: 727-499-0351
  • Fax: 727-223-0157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY9042
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY9042
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9042
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY9042
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPY9042
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY9042
License Number StateFL

VIII. Authorized Official

Name: DR. JAMES R. KINNEY JR.
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 727-463-2863