Provider Demographics
NPI:1326602525
Name:KENNEY, MELISSA DAWN
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWN
Last Name:KENNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:KING AND QUEEN COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23085-0007
Mailing Address - Country:US
Mailing Address - Phone:804-785-5977
Mailing Address - Fax:804-785-5885
Practice Address - Street 1:242 ALLENS CIR
Practice Address - Street 2:
Practice Address - City:KING AND QUEEN COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23085-2007
Practice Address - Country:US
Practice Address - Phone:804-785-5977
Practice Address - Fax:804-785-5885
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker