| Joseph Kennell Phd | |
|
3705 Emerson Ave Parkersburg WV 26104-1118 | |
| (304) 865-0272 | |
| (304) 865-0265 |
| Full Name | Joseph Kennell Phd |
|---|---|
| Speciality | Psychologist |
| Location | 3705 Emerson Ave, Parkersburg, West Virginia |
| Authorized Official Name and Position | Debbie M Tippens (OFFICE MANAGER) |
| Authorized Official Contact | 3048650274 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph Kennell Phd 3705 Emerson Aveune Parkersburg WV 26104-1118 Ph: (304) 865-0272 | Joseph Kennell Phd 3705 Emerson Ave Parkersburg WV 26104-1118 Ph: (304) 865-0272 |
| NPI Number | 1346657426 |
|---|---|
| Provider Enumeration Date | 07/21/2014 |
| Last Update Date | 07/25/2014 |
| Medicare PECOS PAC ID | 9638399660 |
|---|---|
| Medicare Enrollment ID | O20140925001252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346657426 | NPI | - | NPPES |
| 0163900000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 557 (West Virginia) | Primary |
| Provider Name | Joseph E Kennell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649305988 PECOS PAC ID: 1355440231 Enrollment ID: I20070618000177 |
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