Provider Demographics
NPI:1780196444
Name:KENNY, JOI ELLEN (FAMILY PARTNER)
Entity type:Individual
Prefix:MRS
First Name:JOI
Middle Name:ELLEN
Last Name:KENNY
Suffix:
Gender:F
Credentials:FAMILY PARTNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2703
Mailing Address - Country:US
Mailing Address - Phone:978-210-0744
Mailing Address - Fax:
Practice Address - Street 1:800 CUMMINGS CTR STE 266
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6175
Practice Address - Country:US
Practice Address - Phone:978-921-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health