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General NPI Number Information
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NPI Number | 1700795986
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Entity Type | Individual
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Provider Name | KENNEDY JOHNSTON
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 905 ALICE ST
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City | DENTON
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State | TX
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Zip | 76201-2873
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Country | US
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Telephone | 214-901-4167
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Fax |
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Provider Business Mailing Address
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Address Line | 169 MADISON AVE STE 15011
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone |
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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 | 93040
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License Number State | TX
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