Provider Demographics
NPI:1366013377
Name:KENNEDY, SARA M (LMHC, LPC, MS CMHC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:KENNEDY
Suffix:
Gender:
Credentials:LMHC, LPC, MS CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8247 CORNER PINE WAY
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5539
Mailing Address - Country:US
Mailing Address - Phone:941-879-6186
Mailing Address - Fax:
Practice Address - Street 1:8247 CORNER PINE WAY
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5539
Practice Address - Country:US
Practice Address - Phone:941-879-6186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health