KENNEDY CONSULTATION & WELLNESS NPI 1508780404

NPI Information

  • NPI: 1508780404
  • Provider Name: KENNEDY CONSULTATION & WELLNESS
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 1611 W CENTRE AVE STE 110
    PORTAGE, MI
    ZIP 49024
  • Phone: (269) 350-4157

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NPI Details

KENNEDY CONSULTATION & WELLNESS is a mental health (including community mental health center) clinic center in Portage, MI. KENNEDY CONSULTATION & WELLNESS NPI is 1508780404. The provider is registered as an organization entity type.

The provider's business location address is:

1611 W CENTRE AVE STE 110
PORTAGE, MI
ZIP 49024-344
Phone: (269) 350-4157

The provider's authorized official is Alicia Rene Kennedy .
The authorized official title is Owner and has the following contact phone number (269) 364-4157.

The enumeration date for this NPI number is 8/5/2026 and was last updated on 8/5/2026.

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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

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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