Kennedy, Kert R
Kennedy, Kert R is an sole proprietor health care provider with primary practice located at 223 N 3Rd St Ste 210 , Muskogee OK 74401-6687. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Kennedy, Kert R can be contacted via phone (918) 910-0014.Contact Information
Primary practice address
223 N 3Rd St Ste 210
Muskogee OK 74401-6687
Phone: (918) 910-0014
Fax: (888) 519-9460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | Oklahoma |
Profile Details
| NPI number | 1760663041 |
|---|---|
| LBN Legal business name | Kennedy, Kert R |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2007 |
| Last updated | Jun 11th, 2019 - about 7 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760663041 | NPPES |
| Oklahoma | MEDICAID | 200364960A |
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