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Individual
SUSAN MARIE KENNEDY
Active
Individual
SUSAN MARIE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CASAC2, FPA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10816
NY
104100000X
Social Worker
Primary
048762
NY
1041C0700X
Clinical Social Worker
094851
NY
175T00000X
Peer Specialist
—
NY
Other
Enumeration date
10/02/2018
Last updated
03/09/2023
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