Individual
MRS. MARLA CATHERINE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LP LMFT
Contact information
Practice address
4103 EAST LAKE ST., MINNEAPOLIS, MN 55406-2259
(651) 645-6020
(651) 645-6020
Mailing address
2259 SUMMIT AVE., SAINT PAUL, MN 55105-1002
(651) 645-3303
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP 1248
MN
106H00000X
Marriage & Family Therapist
0666
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0666
MARRIAGE AND FAMILY LICEN
MN
05
—
72325277000
—
MN
01
—
BC 1GO74KE
BLUE CROSS
MN
01
—
HP36121
HEALTH PARTNERS OLD
MN
01
—
LP1248
PSYCHOLOGY LICENSE
MN
Enumeration date
04/26/2007
Last updated
09/11/2025
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