ROBERT J KENNERLEY PHD PA NPI 1003053646

NPI Information

  • NPI: 1003053646
  • Provider Name: ROBERT J KENNERLEY PHD PA
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 265 N CAUSEWAY
    NEW SMYRNA BEACH, FL
    ZIP 32169
  • Phone: (386) 423-9161

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NPI Details

ROBERT J KENNERLEY PHD PA is an adult mental health clinic center in New Smyrna Beach, FL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. ROBERT J KENNERLEY PHD PA NPI is 1003053646. The provider is registered as an organization entity type.

The provider's business location address is:

265 N CAUSEWAY
NEW SMYRNA BEACH, FL
ZIP 32169-239
Phone: (386) 423-9161
Fax: (386) 423-3094

The provider's authorized official is Robert John Kennerley .
The authorized official title is Psychologist and has the following contact phone number (386) 423-9161.

The enumeration date for this NPI number is 1/20/2009 and was last updated on 8/26/2010.

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
1261QM0855XClinic/CenterAdolescent and Children Mental HealthPY6507FLORIDANo
2261QM0850XClinic/CenterAdult Mental HealthPY6507FLORIDAYes

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: 11/21/2025

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