Maxwell B Kennedy, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT000585 Issued in GA

Practice address

106 Oak St Ste a
Statesboro, GA 30458-0988

Phone

(912) 682-2709

Fax

(912) 764-5661

NPI assigned

Aug 21, 2009

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sapelo Counseling Center

  • Marriage & Family Therapist
  • Statesboro, GA
  • NPI 1942355888
  NPD (past) Authorized official

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250812800000",
    "number": "1265664403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304590373",
            "telephone_number": "912-682-2709",
            "fax_number": "912-764-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 OAK ST STE A",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580988",
            "telephone_number": "912-682-2709",
            "fax_number": "912-764-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MAXWELL",
        "middle_name": "B",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-21",
        "last_updated": "2009-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT000585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tori Kearns, PH.D.
• Jadarrius Keaton
• Alexa Kelley, CLC
• Kassandra Kelly, ATC, LAT
• Kendall M Griffith MD LLC
• Sarah Kent, IBCLC
• Isabella Kersey
• Katherine Elizabeth Key
• Mbill Shadman Khan
• Les J. Kicklighter, D.M.D.

• Marriage & Family Therapist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; 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.