Provider Demographics
NPI:1346354263
Name:KENNEY, JUDITH A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:A
Last Name:KENNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 GRUBB RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3504
Mailing Address - Country:US
Mailing Address - Phone:610-653-4884
Mailing Address - Fax:610-993-8798
Practice Address - Street 1:150 GRUBB RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3504
Practice Address - Country:US
Practice Address - Phone:610-653-4884
Practice Address - Fax:610-993-8798
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003912101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional