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General NPI Number Information
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NPI Number | 1356512099
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Entity Type | Individual
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Provider Name | JAMES E. KENNEDY LISW-S
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Gender | Male
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 2285 BENDEN DR
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City | WOOSTER
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State | OH
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Zip | 44691-2568
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Country | US
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Telephone | 330-264-9029
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Fax | 330-263-7251
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Provider Business Mailing Address
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Address Line | 898 OAKLAND AVE
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City | AKRON
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State | OH
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Zip | 44310-2104
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Country | US
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Telephone | 330-466-7365
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I0002657-SUPV
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License Number State | OH
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