Provider Demographics
NPI:1366677668
Name:KENNEDY, JOHN F (PHD LMFT, LPC-MHSP)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:KENNEDY
Suffix:
Gender:M
Credentials:PHD LMFT, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4452 ANDREW JACKSON PKWY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1417
Mailing Address - Country:US
Mailing Address - Phone:615-398-1711
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL STE 120
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1086
Practice Address - Country:US
Practice Address - Phone:615-398-1711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2426101YM0800X
TN748106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health