Provider Demographics
NPI:1215616537
Name:KENNINGTON, BRITIAN (LAC)
Entity type:Individual
Prefix:
First Name:BRITIAN
Middle Name:
Last Name:KENNINGTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:BRITIAN
Other - Middle Name:
Other - Last Name:KENNINGTON-CHESANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:618 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-3969
Mailing Address - Country:US
Mailing Address - Phone:620-342-2239
Mailing Address - Fax:
Practice Address - Street 1:618 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-3969
Practice Address - Country:US
Practice Address - Phone:620-342-2239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01845101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)