| Doctor Name: | BRADLEY S KENNINGTON |
| NPI Number: | 1184766743 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMFT, LPC |
| License Number: | 18763 |
| Business Practice Address: | 4613 Bee Caves Rd Suite 204 West Lake Hills, TX - 787465203 |
| Business Phone Number: | 5127322400 |
| Business Fax Number: | 5127322404 |
| Mailing Address: | 4613 Bee Caves Rd, Suite 204 WEST LAKE HILLS |
| State: | TX |
| Postal Code: | 787465203 |
| Phone Number: | 5127322400 |
| Fax Number: | 5127322404 |
| NPI Enumeration Date: | 02/12/2007 |
| NPI Last Update Date: | 09/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 18763 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |