Individual
MR. KENRICK ALFRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T, CAMS II
Contact information
Practice address
608 JOHNSON AVENUE, SUITE 2, NORTH BABYLON, NY 11703-1208
(631) 575-8062
(631) 761-9475
Mailing address
608 JOHNSON AVE STE 2, BOHEMIA, NY 11716-2690
(631) 575-8062
(631) 761-9475
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33671
NY
Other
Enumeration date
11/09/2017
Last updated
12/18/2017
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