Linda T Kennedy, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0861 Issued in NM

Practice address

509 11TH St
Suite a
Las Vegas, NM 87701-3958

Phone

(505) 425-3155

Fax

(505) 425-3155

NPI assigned

Aug 31, 2006

Last updated

Mar 31, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1396856258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877010236",
            "telephone_number": "505-425-3155",
            "fax_number": "505-425-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 11TH ST",
            "address_2": "SUITE A",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877013958",
            "telephone_number": "505-425-3155",
            "fax_number": "505-425-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LINDA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "0861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76071235",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.