# SOUTH COUNTY WELLNESS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861555690
- **Authorized official:** MRS. CATHY L KENNEDY PCNS (PRESCRIPTIVE CLINICAL NURSE SPECIAL)
- **Authorized official phone:** (401) 667-7079

## Contact information

- **Practice address:** 1130 TEN ROD RD, SUITE E302, NORTH KINGSTOWN, RI 02852-4161
- **Practice address phone:** (401) 667-7079
- **Mailing address:** 1130 TEN ROD RD, SUITE E302, NORTH KINGSTOWN, RI 02852-4161
- **Mailing address phone:** (401) 667-7079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | PPNS00010 | RI | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | PPNS00047 | RI | Yes |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 08/22/2020