M.J. Kennedy, PH.D. Incorporated

Primary specialty

PsychologistTaxonomy code 103T00000X

License

22127 Issued in TX

Legal business name

M.J. KENNEDY, PH.D. INCORPORATED

Practice address

16846 Royal Crest Dr
Houston, TX 77058-2529

Phone

(281) 480-9291

Fax

(281) 218-6116

NPI assigned

Sep 5, 2007

Organization subpart

No

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

Authorized official

Name

Martha J Kennedy, PH.D.NPI 1174503247

Title

Owner

Phone

(281) 480-9291

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martha J Kennedy, PH.D.

  • Clinical Psychologist
  • Houston, TX
  • NPI 1174503247
  NPD (past) Authorized official

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1184818965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16846 ROYAL CREST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582529",
            "telephone_number": "281-480-9291",
            "fax_number": "281-218-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16846 ROYAL CREST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582529",
            "telephone_number": "281-480-9291",
            "fax_number": "281-218-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.J. KENNEDY, PH.D. INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-480-9291",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "22127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100040801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.