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General NPI Number Information
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NPI Number | 1851446165
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Entity Type | Individual
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Provider Name | ROXANNE M. KENNEDY MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 340 E MAPLE AVE STE 207
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City | LANGHORNE
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State | PA
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Zip | 19047-2852
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Country | US
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Telephone | 267-980-2374
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Fax | 215-497-9762
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Provider Business Mailing Address
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Address Line | 94 COLONIAL DR
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City | NEWTOWN
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State | PA
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Zip | 18940-1102
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Country | US
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Telephone | 267-980-2374
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Fax | 215-497-9762
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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 | CW013344
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05263000
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License Number State | NJ
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