Provider Demographics
NPI:1407302987
Name:KENYON COUNSELING LLC
Entity Type:Organization
Organization Name:KENYON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:KENYON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-740-7235
Mailing Address - Street 1:109 ROXIE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35633-1329
Mailing Address - Country:US
Mailing Address - Phone:256-740-7235
Mailing Address - Fax:256-275-7391
Practice Address - Street 1:109 ROXIE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35633-1329
Practice Address - Country:US
Practice Address - Phone:256-740-7235
Practice Address - Fax:256-275-7391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2038251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health