Individual
KATHLEEN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
38882 MENTOR AVE, WILLOUGHBY, OH 44094-7875
(440) 953-9999
Mailing address
38882 MENTOR AVE, WILLOUGHBY, OH 44094-7875
(440) 953-9999
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
S.1600057
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0279132
—
OH
Enumeration date
01/29/2016
Last updated
09/13/2019
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