Kennedy, Michael

Kennedy, Michael is an individual health care provider with primary practice located at 55 Cherry Ln , Wakefield RI 02879-3617. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Kennedy, Michael can be contacted via phone (401) 364-7705.

Contact Information

Primary practice address
55 Cherry Ln Wakefield RI 02879-3617
Phone: (401) 364-7705
Fax: (401) 364-9104
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1316193808
LBN Legal business name Kennedy, Michael
Credentials LCDP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2008
Last updated Apr 28th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316193808 NPPES
Rhode Island MEDICAID MK76619
Rhode Island Other 30342
Rhode Island MEDICAID GH57134

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