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Individual
MAX ANDREW KENWORTHY
Active
Individual
MAX ANDREW KENWORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD00001395
CO
101YM0800X
Mental Health Counselor
LPC0016601
CO
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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