Provider Demographics
NPI:1992840870
Name:KENNEY, MELISSA DAWN (MA, LMHP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWN
Last Name:KENNEY
Suffix:
Gender:F
Credentials:MA, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 N. 55TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504
Mailing Address - Country:US
Mailing Address - Phone:402-601-2617
Mailing Address - Fax:
Practice Address - Street 1:5539 S 27TH ST
Practice Address - Street 2:STE 206
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-1611
Practice Address - Country:US
Practice Address - Phone:402-423-3600
Practice Address - Fax:402-423-3690
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health