Michael Kennedy, PHD, ARNP

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

AP30002443 Issued in WA

Practice address

1116 Summit Ave
Therapeutic Health Services
Seattle, WA 98101-2831

Phone

(206) 323-0930

NPI assigned

Jun 30, 2015

Last updated

Jun 30, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Michael Glenn Kennedy Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wandee J. Pryor, Psy.D., LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Poulsbo, WA
  • NPI 1376043232
  NPD (past)

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1023491743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1275",
            "address_2": "251 EAST NORTHCREST DRIVE",
            "city": "ALLYN",
            "state": "WA",
            "postal_code": "985241275",
            "telephone_number": "360-990-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 SUMMIT AVE",
            "address_2": "THERAPEUTIC HEALTH SERVICES",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012831",
            "telephone_number": "206-323-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PHD, ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00087927",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "AP30002443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "KENNEDY",
            "middle_name": "GLENN",
            "prefix": "MR.",
            "credential": "PHD, ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Krista Shea Kennedy, MD
• Lance Kennedy
• Lea Lehua Kennedy, LMFTA
• Lesley H. Kennedy, CNM
• Melissa J. Kennedy, PHD
• Mitchell Iung Kennedy, MD
• Patricia Kennedy, M.S.W.
• Rachel E Kennedy, MA, LMHC
• Samuel Kennedy
• Serena Marie Kennedy, LMP

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Seattle, WA
• Providers in Seattle, WA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.