| Kennedy Psychological Services | |
|
155 Ne 100th St Seattle WA 98125-8012 | |
| (206) 619-9833 | |
| Not Available |
| Full Name | Kennedy Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 155 Ne 100th St, Seattle, Washington |
| Authorized Official Name and Position | Melissa Jane Kennedy (PRESIDENT/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2066199833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Psychological Services 3432 E Florence Ct Seattle WA 98112-4936 Ph: (206) 619-9833 | Kennedy Psychological Services 155 Ne 100th St Seattle WA 98125-8012 Ph: (206) 619-9833 |
| NPI Number | 1174922322 |
|---|---|
| Provider Enumeration Date | 08/13/2014 |
| Last Update Date | 08/13/2014 |
| Medicare PECOS PAC ID | 0143440099 |
|---|---|
| Medicare Enrollment ID | O20140929000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174922322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 000003822 (Washington) | Primary |
| Provider Name | Melissa Jane Kennedy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588741961 PECOS PAC ID: 1052531902 Enrollment ID: I20140929000381 |
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