Nicole Marie Kennedy, PH-MHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P09847 Issued in NY

Practice address

221 Hamilton St
Ogdensburg, NY 13669-1707

Phone

(315) 541-3042

NPI assigned

May 22, 2018

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1164913489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 FORD ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691704",
            "telephone_number": "315-393-3074",
            "fax_number": "315-393-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 HAMILTON ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691707",
            "telephone_number": "315-541-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PH-MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P09847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Kantor, DO
• Aleksandr Karabats
• Martha A Keesler, LMSW
• Anitra E Kellar, REGISTERED PROFESSIO
• Kelly Lynn Scott, MD
• Syeannah M Kennedy
• Melissa Kenney, PSYD
• Srinivas Ketharaju, MD
• Keystone America
• Trudy M Kiah, RPAC

• Mental Health Counselor in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.