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NPI Code Detail

MEDICARE: KRISTI KENNEDY LPC

MEDICARE: KRISTI KENNEDY LPC
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
1101YP2500XProfessional CounselorC.1700833OH

General Provider Information

NPI Number : 1467954529
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI KENNEDY LPC
Provider Business Mailing Address
First Line : 6140 LARCHWAY RD
Second Line :
City : TOLEDO
State : OH
Zip : 43613-1020
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4159 N HOLLAND SYLVANIA RD STE 205
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4801
Country : US
Telephone Number : 419-318-5286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2018
Last Update Date : 03/05/2018

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Directions to “ KRISTI KENNEDY LPC” Practice Location

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