Provider Demographics
NPI:1023859873
Name:NAPOLI, KENNETH W
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:W
Last Name:NAPOLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 DOUGLASS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-6606
Mailing Address - Country:US
Mailing Address - Phone:601-672-5219
Mailing Address - Fax:
Practice Address - Street 1:117 PARK CIRCLE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39232-8878
Practice Address - Country:US
Practice Address - Phone:601-672-5219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health