Provider Demographics
NPI:1700338134
Name:KENNEDY, LORI (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5947 CHATHAM DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1978
Mailing Address - Country:US
Mailing Address - Phone:214-502-3602
Mailing Address - Fax:
Practice Address - Street 1:7242 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-5359
Practice Address - Country:US
Practice Address - Phone:214-502-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72750101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health