KELLIE KENNEDY CDCA NPI 1457955478

NPI Information

NPI: 1457955478
Provider Name: KELLIE KENNEDY, CDCA
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
7540 NEW WEST RD
TOLEDO, OH
ZIP 43617
Phone: (866) 203-0308
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Kellie Kennedy, CDCA is an addiction (substance use disorder) counselor in Toledo, OH. Kellie Kennedy, CDCA NPI is 1457955478. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7540 NEW WEST RD
TOLEDO, OH
ZIP 43617-200
Phone: (866) 203-0308

The enumeration date for this NPI number is 11/30/2020 and was last updated on 10/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	174701	OHIO	Yes
2	101YM0800X	Counselor	Mental Health			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0425228	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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