Van Kennedy, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C7713 Issued in OR

Practice address

132 E Broadway Ste 303
Eugene, OR 97401-3154

Phone

(541) 525-4460

NPI assigned

Aug 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Well Aware Integrative Care LLC

  • Psychiatry Physician
  • Eugene, OR
  • NPI 1801587209
  NPD
• Well Aware Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eugene, OR
  • NPI 1700549250
  NPD

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

{
    "created_epoch": "1628294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1144994666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY STE 303",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013154",
            "telephone_number": "541-525-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY STE 303",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013154",
            "telephone_number": "541-525-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "VAN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-07",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C7713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Kennedy
• Kristin Finch Kennedy, PT
• Marcia J Kennedy, LCSW
• Robert Kennedy
• Suzanne Kennedy, LMT
• Kenneth E Zimmerman Pmhnp
• Markisha Kiahnna Kenney, PSS, CHW
• Christin Rachel Kenny
• Kensington Rehabilitation Health Center LLC
• Analidia Kensler

• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.