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General NPI Number Information
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NPI Number | 1508523093
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Entity Type | Individual
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Provider Name | KATHRYN BLANEY KENNEDY LPC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2021
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 830 SHERMAN AVE
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City | HAMDEN
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State | CT
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Zip | 06514-1147
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Country | US
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Telephone | 203-288-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 123 WATER ST APT 411
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City | NORWALK
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State | CT
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Zip | 06854-3177
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Country | US
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Telephone | 443-798-8542
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5280
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License Number State | CT
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