Provider Demographics
NPI:1114293040
Name:KENNEDY, FRANKIE MAE (LMHC, LCAS, LPC, CDP)
Entity Type:Individual
Prefix:DR
First Name:FRANKIE
Middle Name:MAE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LMHC, LCAS, LPC, CDP
Other - Prefix:DR
Other - First Name:FRANKIE
Other - Middle Name:MAE
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LMHC, CDP
Mailing Address - Street 1:4502 42ND AVE SW APT 524
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-5850
Mailing Address - Country:US
Mailing Address - Phone:206-747-6989
Mailing Address - Fax:
Practice Address - Street 1:4502 42ND AVE SW APT 503
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-5846
Practice Address - Country:US
Practice Address - Phone:910-689-4311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60818170101YA0400X
WA60505969101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)