MEDICARE: MELANIE J. 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
1	101YP2500X	Professional Counselor	1944	AL

General Provider Information

NPI Number	:	1952556581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE J. KENNEDY LPC

Provider Business Mailing Address
First Line	:	2306 2ND AVE. NORTH
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35203
Country	:	US
Telephone Number	:	205-790-6256
Fax Number	:

Provider Business Practice Location Address
First Line	:	2306 2ND AVE N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35203-3808
Country	:	US
Telephone Number	:	205-790-6256
Fax Number	:

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

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	11/24/2008

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