Organization
ELIZABETH KENNEDY A LICENSED CLINICAL SOCIAL WORKER, A PROFESSIONAL CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGILIA ELIZABETH KENNEDY LCSW (CEO)
(805) 878-1863
Entity
Organization
Contact information
Practice address
1505 SHEPARD DR STE 204, SANTA MARIA, CA 93454-7016
(805) 765-2300
(805) 944-1543
Mailing address
PO BOX 7842, SANTA MARIA, CA 93456-7842
(805) 878-1863
(805) 944-1543
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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