Individual
DR. DAVID R. KENIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 531-3500
(219) 462-3975
Mailing address
354 WORCHESTER DR, APT. 8-B, VALPARAISO, IN 46383-1333
(219) 531-3500
(219) 462-3975
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20040382
IN
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
20040382
IN
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
10/14/2005
Last updated
09/11/2025
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