Individual
KENNEDY HAVERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
126 GENERAL CHENNAULT ST NE, ALBUQUERQUE, NM 87123-2515
(505) 900-3833
(505) 212-6422
Mailing address
126 GENERAL CHENNAULT ST NE, ALBUQUERQUE, NM 87123-2515
(505) 900-3833
(505) 212-6422
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2023-0169
NM
1041C0700X
Clinical Social Worker
SWB-2025-0878
NM
Other
Enumeration date
04/25/2023
Last updated
08/19/2025
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