MR. CHARLES M KENNEDY (NPI# 1730320805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730320805 |
| Entity Type | Individual |
| Full Name | MR. CHARLES M KENNEDY |
| Credential | NCAC II |
| Practice Address |
171 Sw Court St Dallas OR 97338-3112 |
| Practice Telephone | 5038311423 |
| Practice Fax Number | 5038311573 |
| Mailing Telephone | 5038311423 |
| Mailing Fax Number | 5038311573 |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 97-04-91 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124455985 | Charles Kennedy Jr. | Specialist | 8454 Northview Pass, Fair Oak Ranch, TX 78015 | 2013-10-10 |
| 1942576111 | Charles Derensbough Kennedy | Internal Medicine | 229 Sycamore Grove St, Simi Valley, CA 93065-7342 | 2012-03-31 |
| 1902981624 | Charles A Kennedy | Social Worker | 4120 N 20th St Ste B, Phoenix, AZ 85016-6022 | 2006-10-25 |
| 1750485116 | Charles Reed Kennedy | Psychologist | 112 Holland Ave, Albany, NY 12208-3404 | 2006-09-07 |
| 1124477708 | Charles Kennedy | Student in an Organized Health Care Education/Training Program | 500 Cherry St, Bluefield, WV 24701-3306 | 2016-06-06 |
| 1467824425 | Charles T. Kennedy Jr. | Social Worker | 1309 S Linden Rd Ste C, Flint, MI 48532-3443 | 2015-10-29 |
| 1548583172 | Charles Reggie Kennedy Sr. | Orthotist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2010-03-10 |
| 1528260130 | Charles J Kennedy | Psychologist | 214 College Park Plz, Johnstown, PA 15904-2833 | 2007-06-05 |
| 1790896199 | Charles A. Kennedy | Dentist | 1000 Parkway Rd, South Charleston, WV 25309-9418 | 2006-08-31 |
| 1912984428 | Charles C Kennedy | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-12-27 |
| Street Address |
171 SW COURT ST |
| City | DALLAS |
| State | OR |
| Zip Code | 97338-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265673339 | Tomoko Gersch | Counselor | 171 Sw Court St, Dallas, OR 97338-3112 | 2009-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164932042 | Stephanie Marie Renfro | Massage Therapist | 289 E Ellendale Ave #601, Dallas, OR 97338 | 2017-10-05 |
| 1588185953 | Herbert Starr Woodward IIi | Dentist | 201 Se Washington St, Dallas, OR 97338 | 2017-07-06 |
| 1851708077 | David Mooso | Pharmacist | 321 Nw Kings Valley Highway, Dallas, OR 97338 | 2014-07-21 |
| 1841615556 | Leslie Lytle | Counselor | 1020 Sw Maple St., Dallas, OR 97338 | 2014-03-04 |
| 1205265493 | Chung-fan Ni | Counselor | 182 S. W. Academy St., Academy Building, Dallas, OR 97338 | 2013-11-07 |
| 1215204300 | Ron Fritz | Counselor | 239 E. Ellendale, Suite 602, Dallas, OR 97338 | 2011-11-17 |
| 1235420167 | Deborah Kennedy | Counselor | 527 Ne Fern Ave, Dallas, OR 97338 | 2011-04-26 |
| 1821229774 | Chelsea Ruhoff Lee | Physician Assistant | 1000 Se Uglow Avenue, Flaming Medical Center, Dallas, OR 97338 | 2009-07-27 |
| 1013128560 | Larry J Vuylsteke | Social Worker | 182 S.w. Academy, Dallas, OR 97338 | 2007-05-25 |
| 1093926123 | Justin W Reed | Counselor | Academy Building, 182 S.w. Academy St. Suite 304, Dallas, OR 97338 | 2007-05-24 |
| Find all providers in zip 97338 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003416389 | Megan Marie Daniel | Counselor | 11040 Mccree Rd, Dallas, TX 75238-3033 | 2020-10-27 |
| 1265043871 | Stephanie Faye Mcgary | Counselor | 6935 Rondo Dr, Dallas, TX 75241-3791 | 2020-08-17 |
| 1811507809 | Anita Ann Rutherford | Counselor | 14900 Lasater Rd Tr 236, Dallas, TX 75253 | 2020-08-04 |
| 1811507981 | U Got This Therapy Services Pllc | Counselor | 11325 Pegasus St Ste W210, Dallas, TX 75238-5203 | 2020-08-04 |
| 1659980829 | Christopher Thomas Wolff Jr. | Counselor | 17214 Stedman Dr, Dallas, TX 75252-5743 | 2020-07-23 |
| 1053929380 | Krystal Lee Skaggs | Counselor | 2035 Cullen Dr, Dallas, TX 75206-7127 | 2020-07-22 |
| 1922624634 | Collins Counseling Center | Counselor | 6060 N Central Expy Ste 240, Dallas, TX 75206-5203 | 2020-06-18 |
| 1497375562 | Rachel Miriam Berger | Counselor | 13500 Midway Rd Ste 404, Dallas, TX 75244-5154 | 2020-04-19 |
| 1366073199 | Shawndell Springer | Counselor | 4734 Hamilton Ave, Suite 202, Dallas, TX 75223-3418 | 2020-01-30 |
| 1235779182 | James Jordan Greenwald | Counselor | 6510 Abrams Rd Ste 413, Dallas, TX 75231-7217 | 2020-01-08 |
| Find all providers in DALLAS | ||||
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| 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.