Active NPI
Sally I Kennedy, LISW
- Mental Health Counselor
- Dayton, OH
National Provider Identifier
1275712374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- I0004594
- Practice address
- 600 Wayne Ave
Dayton, OH 45410 - Phone
- (937) 496-2000
- Fax
- (937) 496-2185
- NPI assigned
- Oct 25, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | I0004594 | OH | Primary |
Addresses
Primary practice location
600 Wayne Ave
Dayton, OH 45410
Mailing address
600 Wayne Ave
Dayton, OH 45410
Phone (937) 496-2000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193270400000",
"number": "1275712374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 WAYNE AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "45410",
"telephone_number": "937-496-2000",
"fax_number": "937-496-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WAYNE AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "45410",
"telephone_number": "937-496-2000",
"fax_number": "937-496-2185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "SALLY",
"middle_name": "I",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-25",
"last_updated": "2007-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "I0004594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.