Provider Demographics
NPI:1700474194
Name:KENNEDY CONSULTING LCSW, PC
Entity Type:Organization
Organization Name:KENNEDY CONSULTING LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-517-8325
Mailing Address - Street 1:350 CENTRAL PARK W APT 15E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6504
Mailing Address - Country:US
Mailing Address - Phone:917-517-8325
Mailing Address - Fax:
Practice Address - Street 1:350 CENTRAL PARK W APT 15E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6504
Practice Address - Country:US
Practice Address - Phone:917-517-8325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-01
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1801821368OtherINDIVIDUAL NPI- MICHELLE KENNEDY LCSW