=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306722913
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KENNEDY CHRISTIN HONORE LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2025
-----------------------------------------------------
Last Update Date | 08/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1030 FAYETTEVILLE RD SE
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30316-2921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-486-9034
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | KENNEDY HONORE XLOFAO 2107 FAULKNER ROAD NE
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-461-9660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YS0200X
-----------------------------------------------------
Taxonomy Name | School Counselor
-----------------------------------------------------
License Number | MSW011963
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------