Sha'Juan Kennedy

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001

Phone

(262) 408-1125

NPI assigned

Aug 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kennedy Administration

  • Case Manager/Care Coordinator
  • Milwaukee, WI
  • NPI 1649094715
  NPD Authorized official
• Kennedy'S Circle of Wellness LLC

  • Mental Health Counselor
  • Milwaukee, WI
  • NPI 1942856091
  NPD Authorized official

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

{
    "created_epoch": "1535155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1861973083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W MICHIGAN ST APT 412",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032815",
            "telephone_number": "414-399-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 W BLUEMOUND RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058001",
            "telephone_number": "262-408-1125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2266 N Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532026319",
            "country_code": "US",
            "telephone_number": "414-346-0276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3614 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532081416",
            "country_code": "US",
            "telephone_number": "414-346-0276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SHA'JUAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-25",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7602125",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kelly
• Jill Ann Kelly, R.N.
• Megan Marie Kelnhofer
• Beth Mary Kennedy, MS CCC SLP
• Melanie Ann Kennedy, RBT
• Jennifer Lynn Kenton, PT
• Lowell H. Keppel, M.D.
• Jamya P Kersh
• Therese G. Kerwel, MD
• Kevin a. Harry, O.D.

• Mental Health Counselor in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.