Active NPI
Richard T. Kennedy, PSY.D.
- Clinical Psychologist
- Chehalis, WA
National Provider Identifier
1245255785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00001919
- Practice address
- 57 W Main St
Chehalis, WA 98532-4815 - Phone
- (360) 740-8533
- Fax
- (360) 740-8534
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00001919 | WA | Primary |
Addresses
Primary practice location
57 W Main St
Chehalis, WA 98532-4815
Mailing address
57 W Main St
Chehalis, WA 98532-4815
Phone (360) 740-8533
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Integrated Health Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Centralia, WA
- NPI 1942840160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1245255785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 W MAIN ST",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985324815",
"telephone_number": "360-740-8533",
"fax_number": "360-740-8534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 W MAIN ST",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985324815",
"telephone_number": "360-740-8533",
"fax_number": "360-740-8534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "RICHARD",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00001919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.