MEDICARE: TERESA KENNEDY COUNSELING AND CONSULTING, PLLC

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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1518724921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERESA KENNEDY COUNSELING AND CONSULTING, PLLC

Provider Business Mailing Address
First Line	:	1340 CLOVERLEAF PL
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59106-2486
Country	:	US
Telephone Number	:	406-861-5578
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 CLOVERLEAF PL
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59106-2486
Country	:	US
Telephone Number	:	406-861-5578
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERESA ROSELLE KENNEDY
Credential	:	LCPC
Telephone Number	:	406-861-5578

Provider Enumeration Date	:	03/01/2024
Last Update Date	:	03/01/2024

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