Provider Demographics
NPI:1417088311
Name:MUSAMALI, KENNEDY (LPC)
Entity Type:Individual
Prefix:
First Name:KENNEDY
Middle Name:
Last Name:MUSAMALI
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3385
Mailing Address - Country:US
Mailing Address - Phone:816-333-2040
Mailing Address - Fax:816-333-1039
Practice Address - Street 1:751 E 63RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3385
Practice Address - Country:US
Practice Address - Phone:816-333-2040
Practice Address - Fax:816-333-1039
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003030516101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional