MR. JACK TIMOTHY KENNEDY M.A. LICDC NPI 1861557829

NPI Information

  • NPI: 1861557829
  • Provider Name: MR. JACK TIMOTHY KENNEDY, M.A. LICDC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 8833 CHAPELSQUARE LN
    CINCINNATI, OH
    ZIP 45249
  • Phone: (513) 774-9444

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NPI Details

MR. Jack Timothy Kennedy, M.A. LICDC is an addiction (substance use disorder) counselor in Cincinnati, OH. MR. Jack Timothy Kennedy, M.A. LICDC NPI is 1861557829. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8833 CHAPELSQUARE LN
CINCINNATI, OH
ZIP 45249-705
Phone: (513) 774-9444
Fax: (513) 774-9888

The enumeration date for this NPI number is 12/27/2006 and was last updated on 7/8/2007.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)991698OHIOYes

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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