Organization
KENNEDY HERRMANN & ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA L KENNEDY HERRMANN LCSW, LCAC (PRESIDENT)
(219) 393-9033
Entity
Organization
Contact information
Practice address
7863 BROADWAY STE 236, MERRILLVILLE, IN 46410-5554
(219) 769-2141
(219) 769-2675
Mailing address
PO BOX 10126, MERRILLVILLE, IN 46411-0126
(219) 769-2141
(219) 769-2675
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006146A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000801843
ANTHEM BS
IN
Enumeration date
11/30/2012
Last updated
11/14/2013
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