Provider Demographics
NPI:1366805459
Name:KENNEDY, CHRISTINE (PHD LPC, ACS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:PHD LPC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RADNOR DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4269
Mailing Address - Country:US
Mailing Address - Phone:410-921-9989
Mailing Address - Fax:
Practice Address - Street 1:501 WASHINGTON LN
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3145
Practice Address - Country:US
Practice Address - Phone:215-758-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008599101YM0800X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral