Provider Demographics
NPI:1669361762
Name:SHAUNA KENNEY LLC
Entity type:Organization
Organization Name:SHAUNA KENNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:KENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-833-8938
Mailing Address - Street 1:5104 KNOX FARM RD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4362
Mailing Address - Country:US
Mailing Address - Phone:706-833-8938
Mailing Address - Fax:
Practice Address - Street 1:5104 KNOX FARM RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-4362
Practice Address - Country:US
Practice Address - Phone:706-833-8938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty