| Rachel Kennedy Lcpc Pllc | |
|
11 N Northwest Hwy Ste 114 Park Ridge IL 60068-3452 | |
| (901) 262-4882 | |
| Not Available |
| Full Name | Rachel Kennedy Lcpc Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11 N Northwest Hwy Ste 114, Park Ridge, Illinois |
| Authorized Official Name and Position | Rachel M Kennedy (OWNER, PSYCHOTHERAPIST) |
| Authorized Official Contact | 9012624882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rachel Kennedy Lcpc Pllc 11 N Northwest Hwy Ste 114 Park Ridge IL 60068-3452 Ph: (901) 262-4882 | Rachel Kennedy Lcpc Pllc 11 N Northwest Hwy Ste 114 Park Ridge IL 60068-3452 Ph: (901) 262-4882 |
| NPI Number | 1568195832 |
|---|---|
| Provider Enumeration Date | 07/05/2022 |
| Last Update Date | 07/25/2022 |
| Certification Date | 07/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568195832 | NPI | - | NPPES |
| 1356981245 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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