Provider Demographics
NPI:1568726156
Name:KENNEY, LEVIS WAYNE (LPC)
Entity Type:Individual
Prefix:MR
First Name:LEVIS
Middle Name:WAYNE
Last Name:KENNEY
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 1:325 E UPSAL ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2348
Mailing Address - Country:US
Mailing Address - Phone:215-668-6446
Mailing Address - Fax:
Practice Address - Street 1:325 E UPSAL ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19119-2348
Practice Address - Country:US
Practice Address - Phone:215-668-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA006115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional