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NPI Code Detail

MEDICARE: MORGAN KENNEDY LCSW

MEDICARE: MORGAN KENNEDY LCSW
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
1104100000XSocial Worker080940-1NY

General Provider Information

NPI Number : 1164749651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN KENNEDY LCSW
Provider Business Mailing Address
First Line : 18 MILLER RD
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-2220
Country : US
Telephone Number : 516-330-9789
Fax Number :
Provider Business Practice Location Address
First Line : 18 MILLER RD
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-2220
Country : US
Telephone Number : 516-330-9789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2010
Last Update Date : 12/17/2018

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