Active NPI
James Ryan Kennedy, LP, LAC, LMFT, RN
- Clinical Psychologist
- Denver, CO
National Provider Identifier
1831452374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5731
- Practice address
- 5833 E 33Rd Ave
Denver, CO 80207-2112 - Phone
- (303) 399-9988
- Fax
- (303) 399-9977
- NPI assigned
- Jun 20, 2012
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5731 | CO | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 492 | CO | |
| Professional Counselor | 101YP2500X | 1570 | CO | |
| Marriage & Family Therapist | 106H00000X | 804 | CO | |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 116891 | CO |
Addresses
Primary practice location
5833 E 33Rd Ave
Denver, CO 80207-2112
Mailing address
PO Box 7040
Denver, CO 80207-0040
Phone (303) 399-9988
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5731 | CO | MD | Mental Health Counselor |
| 804 | CO | MD | Professional Counselor |
| 1570 | CO | MD | Clinical Psychologist |
| 492 | CO | MD | Clinical Social Worker |
| 116891 | CO | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1831452374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7040",
"city": "DENVER",
"state": "CO",
"postal_code": "802070040",
"telephone_number": "303-399-9988",
"fax_number": "303-399-9977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5833 E 33RD AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802072112",
"telephone_number": "303-399-9988",
"fax_number": "303-399-9977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JAMES",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "LP, LAC, LMFT, RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-20",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "5731",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "492",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "1570",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "804",
"primary": false
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "CO",
"license": "116891",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.