Provider Demographics
NPI:1376744854
Name:KENNEY, SUSAN MARIE (MHRS)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:KENNEY
Suffix:
Gender:F
Credentials:MHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HOWE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4732
Mailing Address - Country:US
Mailing Address - Phone:916-247-7312
Mailing Address - Fax:916-993-4886
Practice Address - Street 1:650 HOWE AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4732
Practice Address - Country:US
Practice Address - Phone:916-247-7312
Practice Address - Fax:916-993-4886
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker