Provider Demographics
NPI:1811048044
Name:KENNEDY, NANCI (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NANCI
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:NANCI
Other - Middle Name:
Other - Last Name:KIMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:210 KEMEYS COVE AVE
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-2048
Mailing Address - Country:US
Mailing Address - Phone:201-446-6594
Mailing Address - Fax:914-457-2386
Practice Address - Street 1:1133 PLEASANTVILLE RD STE 2E
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1635
Practice Address - Country:US
Practice Address - Phone:914-962-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051900001041C0700X
NY072267-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical