Provider Demographics
NPI:1710055579
Name:KENNA, JOSEPH (PHD LCPC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:KENNA
Suffix:
Gender:M
Credentials:PHD LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WEST MONTGOMERY AVENUE
Mailing Address - Street 2:#110
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4216
Mailing Address - Country:US
Mailing Address - Phone:301-251-8965
Mailing Address - Fax:301-251-0136
Practice Address - Street 1:50 WEST MONTGOMERY AVENUE
Practice Address - Street 2:SUITE 115 STILLPOINT INC
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4216
Practice Address - Country:US
Practice Address - Phone:301-459-7111
Practice Address - Fax:301-459-7112
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0575101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional