Healthcare Provider Details

I. General information

NPI: 1518586742
Provider Name (Legal Business Name): LAUREN E KENNEDY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800A MCKNIGHT RD STE 307
PITTSBURGH PA
15237-6025
US

IV. Provider business mailing address

5111 DUNCAN ST
PITTSBURGH PA
15201-2429
US

V. Phone/Fax

Practice location:
  • Phone: 412-860-6610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS020806
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: