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General NPI Number Information
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NPI Number | 1821687633
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Entity Type | Individual
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Provider Name | RACHAEL LEE KENNEDY MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 10291 N MERIDIAN ST STE 250
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City | CARMEL
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State | IN
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Zip | 46290-1076
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Country | US
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Telephone | 765-426-3076
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Fax |
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Provider Business Mailing Address
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Address Line | 3050 ELM SWAMP RD
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City | LEBANON
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State | IN
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Zip | 46052-9383
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Country | US
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Telephone | 765-426-3076
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33008991A
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License Number State | IN
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