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NPI Code Detail

MEDICARE: ANN M KENNEY LICSW

MEDICARE: ANN M KENNEY LICSW
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
11041C0700XClinical Social Worker1024761MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P07879OTHERMABCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174584163
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN M KENNEY LICSW
Provider Business Mailing Address
First Line : 333 UNION ST
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740
Country : US
Telephone Number : 508-990-0852
Fax Number : 508-990-4777
Provider Business Practice Location Address
First Line : 1311 BEDFORD ST
Second Line :
City : FALL RIVER
State : MA
Zip : 02723-2637
Country : US
Telephone Number : 508-567-1477
Fax Number : 508-567-6494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 06/13/2016

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