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Individual
MARCIA KENNEDY
Active
Individual
MARCIA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCP, LSCSW
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1498
KS
1041C0700X
Clinical Social Worker
4695
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-2454443
—
KS
Enumeration date
05/07/2016
Last updated
10/09/2020
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