James C. Kennedy Jr., PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004652 Issued in GA

Practice address

1190 N Highland Ave NE # 8471
Atlanta, GA 30306-4051

Phone

(470) 398-1919

NPI assigned

Apr 21, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jamie Kennedy Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1063109817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 N HIGHLAND AVE NE # 8471",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064051",
            "telephone_number": "470-398-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N HIGHLAND AVE NE # 8471",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064051",
            "telephone_number": "470-398-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JAMES",
        "middle_name": "C.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "KENNEDY",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katelyn Keniston
• Evesha Kenya Kenlyn
• Kennedy ABA Ga LLC
• Amanda Lauren Kennedy, MS, RDN, LDN, CLC
• Caroline A Kennedy, PA-C
• Jennifer Wing Kennedy, CPNP
• Joakim Kennedy
• John Patrick Kennedy, D.C.
• Joycelyn Kennedy, LMSW
• Margaret Kennedy

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.