Robert J Kennerley PHD PA

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

PY6507 Issued in FL

Legal business name

ROBERT J KENNERLEY PHD PA

Practice address

265 N Causeway
New Smyrna Beach, FL 32169-5239

Phone

(386) 423-9161

Fax

(386) 423-3094

NPI assigned

Jan 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert John Kennerley, PHD

Title

Psychologist

Phone

(386) 423-9161

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1003053646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 N CAUSEWAY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695239",
            "telephone_number": "386-423-9161",
            "fax_number": "386-423-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 N CAUSEWAY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695239",
            "telephone_number": "386-423-9161",
            "fax_number": "386-423-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J KENNERLEY PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "KENNERLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "386-423-9161",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "PY6507",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "FL",
            "license": "PY6507",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Riga, D.O.
• Angela Kay Ritten, DNP, APRN, FNP-BC
• Robert Larry Ritter, R.PH.
• Riverside Care Center, Inc
• Cayleen Rizo, OTR/L
• Robert Sabljak
• Robert W Mosca DO PA
• Taylor Eileen Roberts, APRN
• Andrea J Robins, L.M.T.
• Hugh Robinson III, PTA

• Adult Mental Health Clinic/Center in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.