Jennifer Ann Kennedy, MS, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Hunlock Creek, PA
NPI 1194949404 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194949404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL008504 (PA)
- Practice address
- 20 Michelle Dr
Hunlock Creek, PA 18621-2926 - Phone
- (570) 262-6850
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL008504 | PA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Support Services for Infants and Toddlers, P.C. | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL008504 | PA | Yes |
Addresses
Primary practice location
20 Michelle Dr
Hunlock Creek, PA 18621-2926
Mailing address
514 Country Club Apts
Dallas, PA 18612-8922
Phone (570) 814-2987
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1016189810001 | Medicaid | PA |
Other providers in Hunlock Creek, PA
- Ashley Nicole Grevera
- Patricia Q Herrick
- Home and Mobility Solutions
- Hunlock Creek Vol Ambulance Assoc
- Jennifer Kelley
- Jennifer Lynn Kottler
- Lake Silkworth Ambulance
- Lake Silkworth Volunteer Ambulance Association Inc
- Brian Meeker
- Mindful Moments Pediatric Therapy & Wellness Center, LLC
All providers in Hunlock Creek, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.