Healthcare Provider Details

I. General information

NPI: 1477472553
Provider Name (Legal Business Name): KENNEDY THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 5TH ST STE 204
AMES IA
50010-6259
US

IV. Provider business mailing address

208 5TH ST STE 204
AMES IA
50010-6259
US

V. Phone/Fax

Practice location:
  • Phone: 515-240-4139
  • Fax:
Mailing address:
  • Phone: 515-240-4139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ERIN KENNEDY
Title or Position: SOLE MBR
Credential: LISW
Phone: 515-240-4139