Provider Demographics
NPI:1275732257
Name:KABATT - KENNEDY, LAURA TERESE (LCSW-C, LCSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:TERESE
Last Name:KABATT - KENNEDY
Suffix:
Gender:F
Credentials:LCSW-C, LCSW, ACSW
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:TERESE
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 E BENSON BLVD, STE 504
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4019
Mailing Address - Country:US
Mailing Address - Phone:907-331-0576
Mailing Address - Fax:800-511-7484
Practice Address - Street 1:205 E BENSON BLVD, STE 504
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4019
Practice Address - Country:US
Practice Address - Phone:907-331-0576
Practice Address - Fax:800-511-7484
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2022-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD166991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical