Provider Demographics
NPI:1295996452
Name:KENNEDY, BRANDI NICOLE (LPC)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:NICOLE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 EAST LANSING DRIVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823
Mailing Address - Country:US
Mailing Address - Phone:517-337-2900
Mailing Address - Fax:517-351-1279
Practice Address - Street 1:2720 EAST LANSING DRIVE
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-337-2900
Practice Address - Fax:517-351-1279
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222498101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional