Doctor Name: | LAURIE B KENNEDY |
NPI Number: | 1003884719 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | CW012779 |
Business Practice Address: | 220 Commerce Dr Suite 401 Fort Washington, PA - 190342402 |
Business Phone Number: | 2155405860 |
Business Fax Number: | 2155405864 |
Mailing Address: | 220 Commerce Dr, Suite 401 FORT WASHINGTON |
State: | PA |
Postal Code: | 190342402 |
Phone Number: | 2155405860 |
Fax Number: | 2155405864 |
NPI Enumeration Date: | 03/09/2006 |
NPI Last Update Date: | 07/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW012779 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |