Active NPI
William T Kennedy Jr., L.A.D.C., PLMHP
- Mental Health Counselor
- Grand Island, NE
National Provider Identifier
1841330784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8362
- Practice address
- 715 W Anna St
Grand Island, NE 68801-6713 - Phone
- (308) 398-0350
- Fax
- (308) 398-0352
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LADC-621 | NE | |
| Mental Health Counselor | 101YM0800X | 8362 | NE | Primary |
Addresses
Primary practice location
715 W Anna St
Grand Island, NE 68801-6713
Mailing address
2616 W North Front St
Grand Island, NE 68803-4234
Phone (308) 382-6575
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025551800 | Medicaid | NE | |
| 98340 | Other | NE | BLUECROSS BLUESHIELD |
| LADC-621 | Other | NE | LICENSE ALCOHOL DRUG COUN |
| 600245205 | Other | NE | MAGELLAN |
| PLMHP 8362 | Other | NE | MENTAL HEALTH COUNSELOR |
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 |
|---|---|---|---|
| LADC-621 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| 8362 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1841330784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2616 W NORTH FRONT ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688034234",
"telephone_number": "308-382-6575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 W ANNA ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688016713",
"telephone_number": "308-398-0350",
"fax_number": "308-398-0352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "WILLIAM",
"middle_name": "T",
"name_suffix": "Jr.",
"credential": "L.A.D.C., PLMHP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "LADC-621",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "8362",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025551800",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "98340",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE ALCOHOL DRUG COUN",
"identifier": "LADC-621",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "600245205",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH COUNSELOR",
"identifier": "PLMHP 8362",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.