Provider Demographics
NPI:1346971181
Name:KENNEDY, TODD (LMSW)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 ALLENS CREEK RD STE 111
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3200
Mailing Address - Country:US
Mailing Address - Phone:585-727-1114
Mailing Address - Fax:
Practice Address - Street 1:95 ALLENS CREEK RD STE 111
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3200
Practice Address - Country:US
Practice Address - Phone:585-727-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health