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
Fax: (888) 519-9460
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760663041 NPPES
Oklahoma MEDICAID 200364960A

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