| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MARY ELIZABETH M KENNEDY | 1578131801 | 2023-03-11 |
Mary Elizabeth M Kennedy is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1578131801. Registration indicates Mary Elizabeth M Kennedy is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Professional, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Professional, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Mary Elizabeth M Kennedy LPC |
| Practice Office Address | 2 BRONZE POINTE S STE A SWANSEA, IL US |
| Practice Office Telephone | 6182072547 |
| Mailing Address | 2 BRONZE POINTE S STE A SWANSEA, IL 622268307 US |
| Business Telephone | 6182072547 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 988 N Illinois Route 3 | Waterloo, IL 622981059 | 6189394444 |
| Code | Practice | License No State |
|---|---|---|
| 101YP2500X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Professional Behavioral Health/Substance Abuse/Psychiatry Counselor Professional Behavioral Health & Social Service Providers Counselor | 178.018357
IL |