Kennedy, Brian J

Kennedy, Brian J is an sole proprietor health care provider with primary practice located at 352 State St , North Haven CT 06473-3108. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Kennedy, Brian J can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
352 State St North Haven CT 06473-3108
Phone: (203) 781-4600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1617 Connecticut
Behavioral Health & Social Service Providers / Social Worker 104100000X 11232 Connecticut

Profile Details

NPI number 1972307478
LBN Legal business name Kennedy, Brian J
Credentials CAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 3rd, 2025
Last updated Sep 2nd, 2026 - about last month

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972307478 NPPES
Connecticut MEDICAID 004082286
Connecticut MEDICAID 008022626
Connecticut MEDICAID 008056168
Connecticut MEDICAID 500000315

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