Active NPI
Wendy Kennedy, MA
- Mental Health Counselor
- Phoenix, AZ
National Provider Identifier
1639329410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-0037
- Practice address
- 3450 N 3Rd St
Phoenix, AZ 85012-2331 - Phone
- (602) 265-8338
- Fax
- (602) 265-8574
- NPI assigned
- Sep 29, 2008
- 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 | LPC-0037 | AZ | Primary |
Addresses
Primary practice location
3450 N 3Rd St
Phoenix, AZ 85012-2331
Mailing address
404 W Aero Dr
Payson, AZ 85541-5407
Phone (928) 474-3303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC-0037 | Other | AZ | STATE |
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 |
|---|---|---|---|
| LPC-0037 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1639329410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 W AERO DR",
"city": "PAYSON",
"state": "AZ",
"postal_code": "855415407",
"telephone_number": "928-474-3303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 N 3RD ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122331",
"telephone_number": "602-265-8338",
"fax_number": "602-265-8574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "WENDY",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-29",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LPC-0037",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "LPC-0037",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.