Active NPI
Mary Kay Kennedy, MA,LPC,CACIII
- Professional Counselor
- Highlands Ranch, CO
National Provider Identifier
1598095879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5379
- Practice address
- 2121 E Dad Clark Drive
Highlands Ranch, CO 80130 - Phone
- (303) 916-7772
- NPI assigned
- Jan 8, 2010
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5379 | CO | Primary |
Addresses
Primary practice location
2121 E Dad Clark Drive
Highlands Ranch, CO 80130
Mailing address
9185 E Kenyon Ave
Suite 120
Denver, CO 80237
Phone (303) 916-7772
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5379 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1598095879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9185 E KENYON AVE",
"address_2": "SUITE 120",
"city": "DENVER",
"state": "CO",
"postal_code": "80237",
"telephone_number": "303-916-7772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 E DAD CLARK DRIVE",
"city": "HIGHLANDS RANCH",
"state": "CO",
"postal_code": "80130",
"telephone_number": "303-916-7772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MARY KAY",
"name_prefix": "Mrs.",
"credential": "MA,LPC,CACIII",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-08",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "5379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highlands Ranch, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.