MEDICARE: MS. KENNEDY LANGLOIS NCSP, LPES

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	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1528999265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KENNEDY LANGLOIS NCSP, LPES

Provider Business Mailing Address
First Line	:	1606 ABBEY PL UNIT 241
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3082
Country	:	US
Telephone Number	:	704-713-2132
Fax Number	:

Provider Business Practice Location Address
First Line	:	1606 ABBEY PL UNIT 241
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3082
Country	:	US
Telephone Number	:	704-713-2132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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