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NPI Code Detail

MEDICARE: KENNY FIELDS

MEDICARE: KENNY FIELDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor0734013935VA

General Provider Information

NPI Number : 1023969276
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNY FIELDS
Provider Business Mailing Address
First Line : PO BOX 426
Second Line :
City : CEDAR BLUFF
State : VA
Zip : 24609-0426
Country : US
Telephone Number : 276-821-2260
Fax Number :
Provider Business Practice Location Address
First Line : 169 SUFFOLK AVE STE 1
Second Line :
City : RICHLANDS
State : VA
Zip : 24641-2434
Country : US
Telephone Number : 276-821-2260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2026
Last Update Date : 02/04/2026

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Directions to “ KENNY FIELDS ” Practice Location

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