Healthcare Provider Details

I. General information

NPI: 1386358414
Provider Name (Legal Business Name): TAMARA HURLBURT KENNEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 01/12/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NOYES MENTAL HEALTH AND WELLNESS 9221 ROBERT HART DRIVE
DANSVILLE NY
14437
US

IV. Provider business mailing address

NOYES MENTAL HEALTH AND WELLNESS 9221 ROBERT HART DRIVE
DANSVILLE NY
14437
US

V. Phone/Fax

Practice location:
  • Phone: 585-335-4316
  • Fax: 585-335-3577
Mailing address:
  • Phone: 585-335-4316
  • Fax: 585-335-3577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: