Doctor Name: | MR. BRENDAN CHARLES KENNEDY |
NPI Number: | 1801103106 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CADC II, BS |
License Number: | 4150510000 |
Business Practice Address: | 3793 River Rd N Suite A Keizer, OR - 973034827 |
Business Phone Number: | 5033047002 |
Business Fax Number: | 5033047049 |
Mailing Address: | 3793 River Rd N, Suite A KEIZER |
State: | OR |
Postal Code: | 973034827 |
Phone Number: | 5033047002 |
Fax Number: | 5033047049 |
NPI Enumeration Date: | 09/08/2010 |
NPI Last Update Date: | 09/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 4150510000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |