Organization
RACHEL KENNEDY LCPC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL M KENNEDY LCPC (OWNER, PSYCHOTHERAPIST)
(901) 262-4882
Entity
Organization
Contact information
Practice address
11 N NORTHWEST HWY STE 114, PARK RIDGE, IL 60068-3452
(901) 262-4882
Mailing address
11 N NORTHWEST HWY STE 114, PARK RIDGE, IL 60068-3452
(901) 262-4882
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356981245
—
IL
Enumeration date
07/05/2022
Last updated
07/25/2022
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