Provider Demographics
NPI:1285994087
Name:KENNEDY, KARLYE SHEA
Entity type:Individual
Prefix:MISS
First Name:KARLYE
Middle Name:SHEA
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922-1607
Mailing Address - Country:US
Mailing Address - Phone:781-389-7139
Mailing Address - Fax:
Practice Address - Street 1:161 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:BYFIELD
Practice Address - State:MA
Practice Address - Zip Code:01922-1607
Practice Address - Country:US
Practice Address - Phone:781-389-7139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor