KENNETH ALLEN WYNN (NPI# 1215082706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215082706 |
| Entity Type | Individual |
| Full Name | KENNETH ALLEN WYNN |
| Credential | M.ED., LMHC, LMFT |
| Practice Address |
804 3rd St Suite Ab Neptune Beach FL 32266-5040 |
| Mailing Address |
1390 Stocks St Atlantic Beach FL 32233-2632 |
| Practice Telephone | 9046576063 |
| Mailing Telephone | 9046576063 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2017-03-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH9674 | FL | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | MT2739 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972692192 | Kenneth Orlando Wynn | Dentist | United States Milityary Academy, Dentac, 646 Swift Road, West Point, NY 10996-1905 | 2006-10-12 |
| Street Address |
804 3RD ST SUITE AB |
| City | NEPTUNE BEACH |
| State | FL |
| Zip Code | 32266-5040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164906939 | Stephanie Margaret-timbol Cox | Counselor | 804 3rd St, Neptune Beach, FL 32266-5040 | 2018-09-18 |
| 1790136208 | The Strengths Initiative | Counselor | 804 3rd St, Suite A-b, Neptune Beach, FL 32266-5040 | 2016-06-27 |
| 1164879623 | Teri Pappas | Counselor | 804 3rd St, Suite D, Neptune Beach, FL 32266-5040 | 2016-05-15 |
| 1689069288 | The Healing Playroom, Pllc | Social Worker | 804 3rd St, Suite D, Neptune Beach, FL 32266-5040 | 2015-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174098057 | Margaret Elizabeth Bernhart | Counselor | 800 3rd Street Ste C, Neptune Beach, FL 32266 | 2018-10-08 |
| 1144707753 | Matthew Hickman | Counselor | 804 3rd St Suite Ab, Neptune Beach, FL 32266 | 2018-07-26 |
| 1487172094 | Seabreeze Medical Pa | Internal Medicine | 320 3rd St Ste B, Neptune Beach, FL 32266 | 2017-09-03 |
| 1740714716 | Christine Coleman | Counselor | 804 3rd St Ste A&b, Neptune Beach, FL 32266 | 2017-04-17 |
| 1609227685 | Susan E. Stewart | Acupuncturist | 320 Third Street, Sutie B, Neptune Beach, FL 32266 | 2016-06-30 |
| 1407203078 | Lofton Creek Dental, Pa | Dentist | 109 Azalea Place, Neptune Beach, FL 32266 | 2016-05-24 |
| 1083082895 | Edith Maria Ortega | Internal Medicine | 528 Oceanfront, Neptune Beach, FL 32266 | 2015-09-10 |
| 1689074817 | Elizabeth Phillips Broullire | Pharmacist | 630 Atlantic Blvd., Neptune Beach, FL 32266 | 2014-08-25 |
| 1740614775 | Surfside Dental Center, Pa. | Point of Service | 630-7 Atlantic Blvd., Neptune Beach, FL 32266 | 2013-08-27 |
| 1568725984 | Neptune Beach Pharmacy LLC | Pharmacist | 1529 Atlantic Blvd, Neptune Beach, FL 32266 | 2012-06-20 |
| Find all providers in zip 32266 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568074581 | Reagan Palmer | Counselor | 800 3rd St Ste B, Neptune Beach, FL 32266-5060 | 2020-08-20 |
| 1144707753 | Matthew Hickman | Counselor | 804 3rd St Suite Ab, Neptune Beach, FL 32266 | 2018-07-26 |
| 1740714716 | Christine Coleman | Counselor | 804 3rd St Ste A&b, Neptune Beach, FL 32266 | 2017-04-17 |
| 1831577766 | Anne Louis Morollo | Counselor | 1900 1st St Apt 1, Neptune Beach, FL 32266-4843 | 2015-05-12 |
| 1326425315 | Joanna Lea Ale | Counselor | 2116 Bay Rd, Neptune Beach, FL 32266-1613 | 2015-04-29 |
| 1437401452 | Blaire Taylor | Counselor | 1100 Seagate Ave Apt 126, Neptune Beach, FL 32266-3518 | 2012-10-15 |
| 1629326996 | Jennifer E Wilburn | Counselor | 804 3rd St Ste A-b, Neptune Beach, FL 32266-5040 | 2012-08-16 |
| 1306141890 | Jean Kollen Robertson | Counselor | 700 Seagate Ave, Neptune Beach, FL 32266-3505 | 2011-01-14 |
| 1811225485 | Nicole Pollock Story | Counselor | 808 3rd St Ste A, Neptune Beach, FL 32266-5080 | 2009-11-19 |
| 1790843159 | Susan Morgan Morrison | Counselor | 1122 3rd St Ste 7, Neptune Beach, FL 32266-5067 | 2006-12-05 |
| Find all providers in NEPTUNE BEACH | ||||
| City | NEPTUNE BEACH |
| Zip Code | 32266 |
Please comment or provide details below to improve the information on KENNETH ALLEN WYNN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.