Provider Demographics
NPI:1598454530
Name:KENNEDY, EMILY HARRIS (LAPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:HARRIS
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9123 SE SAINT HELENS ST STE 175
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6858
Mailing Address - Country:US
Mailing Address - Phone:503-427-1737
Mailing Address - Fax:
Practice Address - Street 1:9123 SE SAINT HELENS ST STE 175
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6858
Practice Address - Country:US
Practice Address - Phone:503-427-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR8318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health