Active NPI
Patricia Kennedy, LPC
- Professional Counselor
- Olivette, MO
National Provider Identifier
1205962255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 001239
- Practice address
- 9374 Olivette Street
Olivette, MO 63132-3253 - Phone
- (314) 490-4141
- Fax
- (314) 962-4894
- NPI assigned
- Feb 26, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 001239 | MO | Primary |
| Marriage & Family Therapist | 106H00000X | 300064 | MO |
Addresses
Primary practice location
9374 Olivette Street
Olivette, MO 63132-3253
Mailing address
9374 Olive Street
Olivette, MO 63132-3253
Phone (314) 490-4141
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 |
|---|---|---|---|
| 300064 | MO | MD | Marriage & Family Therapist |
| 001239 | MO | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1205962255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9374 OLIVE STREET",
"city": "OLIVETTE",
"state": "MO",
"postal_code": "631323253",
"telephone_number": "314-490-4141",
"fax_number": "314-962-4894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9374 OLIVETTE STREET",
"city": "OLIVETTE",
"state": "MO",
"postal_code": "631323253",
"telephone_number": "314-490-4141",
"fax_number": "314-962-4894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "PATRICIA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "001239",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MO",
"license": "300064",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olivette, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.