Individual
CARMEN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4710 E 30TH ST, INDIANAPOLIS, IN 46218-3109
(317) 602-3106
Mailing address
1624 N LESLEY AVE, INDIANAPOLIS, IN 46218-5046
(317) 223-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/02/2019
Last updated
03/07/2023
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