Individual
TIANA SAMONE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2335 BURTON ST SE STE 210, GRAND RAPIDS, MI 49506-4669
(616) 236-3600
Mailing address
18632 APPOLINE ST, DETROIT, MI 48235-1315
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401012015
MI
101YM0800X
Mental Health Counselor
6401012015
MI
Other
Enumeration date
07/27/2010
Last updated
07/03/2025
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