Individual
ANTHONY ROSS KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSWA, QMHP
Contact information
Practice address
350 E 11TH AVE, CHRYSALIS WHITEBIRD CLINIC, EUGENE, OR 97401-3246
(541) 683-1641
Mailing address
350 E 11TH AVE, CHRYSALIS WHITEBIRD CLINIC, EUGENE, OR 97401-3246
(541) 683-1641
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
03/28/2016
Last updated
11/06/2017
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