Active NPI
Elizabeth Anne Kennedy, LADC
- Counselor
- Williston, VT
National Provider Identifier
1063733152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 000408
- Practice address
- 2822 St George Rd
Williston, VT 05495-7431 - Phone
- (802) 881-3396
- NPI assigned
- Jun 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 000408 | VT | Primary |
Addresses
Primary practice location
2822 St George Rd
Williston, VT 05495-7431
Mailing address
2822 St George Rd
Williston, VT 05495-7431
Phone (802) 881-3396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000408 | VT | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276300800000",
"number": "1063733152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2822 ST GEORGE RD",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957431",
"telephone_number": "802-881-3396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2822 ST GEORGE RD",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957431",
"telephone_number": "802-881-3396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "ELIZABETH",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-12",
"last_updated": "2010-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "VT",
"license": "000408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.