Active NPI
Thomas Michael Kennedy, LPC
- Mental Health Counselor
- Port Huron, MI
National Provider Identifier
1326145681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6401005178
- Practice address
- 511 Fort St RM 505
Port Huron, MI 48060-3936 - Phone
- (810) 966-0099
- Fax
- (810) 696-7339
- NPI assigned
- Sep 20, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6401005178 | MI | Primary |
Addresses
Primary practice location
511 Fort St RM 505
Port Huron, MI 48060-3936
Mailing address
511 Fort St RM 505
Port Huron, MI 48060-3936
Phone (810) 966-0099
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 |
|---|---|---|---|
| 6401005178 | MI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renewal Christian Counseling Inc | Mental Health | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Mount Clemens, MI
- NPI 1548211535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579737600000",
"number": "1326145681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 FORT ST RM 505",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480603936",
"telephone_number": "810-966-0099",
"fax_number": "810-696-7339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 FORT ST RM 505",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480603936",
"telephone_number": "810-966-0099",
"fax_number": "810-696-7339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2020-01-23",
"certification_date": "2020-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401005178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.