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General NPI Number Information
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NPI Number | 1477646255
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Entity Type | Individual
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Provider Name | LISA M KENNEY LICSW
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 100 CAMBRIDGE ST # 14
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City | BOSTON
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State | MA
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Zip | 02114-2509
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Country | US
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Telephone | 646-941-7645
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Fax | 929-596-7897
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Provider Business Mailing Address
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Address Line | 48 PAUL FRANCIS WAY
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City | PLYMOUTH
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State | MA
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Zip | 02360-2710
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Country | US
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Telephone | 617-710-6147
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 110813
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License Number State | MA
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