Provider Demographics
NPI:1821207184
Name:KENNEY, NEIL JOSEPH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:JOSEPH
Last Name:KENNEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 NW 16TH ST
Mailing Address - Street 2:(116B)
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1624
Mailing Address - Country:US
Mailing Address - Phone:305-575-3215
Mailing Address - Fax:
Practice Address - Street 1:1201 N.W. 16TH STREET (116B)
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1693
Practice Address - Country:US
Practice Address - Phone:305-575-3215
Practice Address - Fax:305-575-7010
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7498103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical