Active NPI
Marilyn Kennedy, MA-COUNSELING
- Professional Counselor
- Greenville, SC
National Provider Identifier
1083179410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7074
- Practice address
- 17 Memorial Medical Dr
Greenville, SC 29605-4407 - Phone
- (864) 283-0637
- NPI assigned
- Feb 11, 2019
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7074 | SC | Primary |
Addresses
Primary practice location
17 Memorial Medical Dr
Greenville, SC 29605-4407
Mailing address
7 Carver St
Due West, SC 29639-9583
Phone (864) 376-9281
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 |
|---|---|---|---|
| 7074 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1083179410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 CARVER ST",
"city": "DUE WEST",
"state": "SC",
"postal_code": "296399583",
"telephone_number": "864-376-9281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 MEMORIAL MEDICAL DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054407",
"telephone_number": "864-283-0637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MARILYN",
"credential": "MA-COUNSELING",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-11",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "7074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.