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Individual

MR. BRIAN J KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CAC

Contact information

Practice address
352 STATE ST, NORTH HAVEN, CT 06473-3108
(203) 781-4600
Mailing address
204 WINSLOW DR, WEST HAVEN, CT 06516-6917
(203) 435-0242

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1617
CT
104100000X
Social Worker
Primary
11232
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004082286
CT
05
008022626
CT
05
008056168
CT
05
500000315
CT
Enumeration date
04/03/2025
Last updated
01/06/2026
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