DR. CHARLES REED KENNEDY (NPI# 1750485116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750485116 |
| Entity Type | Individual |
| Full Name | DR. CHARLES REED KENNEDY |
| Credential | PH. D. |
| Practice Address |
112 Holland Ave Albany NY 12208-3404 |
| Mailing Address |
112 Holland Ave Albany NY 12208 |
| Practice Telephone | 5186265000 |
| Mailing Telephone | 5186265000 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
013371-1 | NY | 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 |
| 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 |
| 1730320805 | Charles M Kennedy | Counselor | 171 Sw Court St, Dallas, OR 97338-3112 | 2009-03-18 |
| 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 |
112 HOLLAND AVE |
| City | ALBANY |
| State | NY |
| Zip Code | 12208-3404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346867314 | Sheri Lynn Mainquist | Psychologist | 850 Stannage Ave Apt 5, Albany, CA 94706-1642 | 2020-06-25 |
| 1528687399 | Rachel Magin | Psychologist | 2 Clara Barton Dr # Mc164, Albany, NY 12208-3472 | 2020-04-13 |
| 1346707270 | Matthew Golley | Psychologist | Samuel S. Stratton Vamc, 113 Holland Avenue, Albany, NY 12208 | 2019-02-27 |
| 1346739950 | James Franklin Boswell | Psychologist | Social Science 399 1400 Washington Avenue, Albany, NY 12222-0001 | 2018-05-09 |
| 1013417286 | Linda Renee Bockheim | Psychologist | 425 2nd Ave Sw Ste 204, Albany, OR 97321-2485 | 2018-02-14 |
| 1700384468 | G.h. Wilber, Psy.d., Pllc | Psychologist | 5 Pine West Plz Ste 511, Albany, NY 12205-5587 | 2018-01-29 |
| 1447775200 | Heidi Rochelle Wright | Psychologist | 1365 Washington Ave Ste 102a, Albany, NY 12206-1098 | 2017-08-13 |
| 1366995508 | Supriya Blair | Psychologist | 1 Ten Broeck St Ste 1, Albany, NY 12210-2521 | 2016-07-24 |
| 1225411341 | Bradley Biggsphd Psychologist P.C. | Psychologist | 142 N Allen St, Suite C, Albany, NY 12206-1700 | 2015-07-07 |
| 1215339171 | Mary Kathleen O'neill | Psychologist | 314 South Manning Blvd., Albany, NY 12208 | 2014-09-23 |
| Find all providers in ALBANY | ||||
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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.