Provider Demographics
NPI:1316310477
Name:KENNEDY, KIRA RINEHART (LCSW)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:RINEHART
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 EXECUTIVE CENTER CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4487
Mailing Address - Country:US
Mailing Address - Phone:501-725-8008
Mailing Address - Fax:501-725-8009
Practice Address - Street 1:4 EXECUTIVE CENTER CT
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4487
Practice Address - Country:US
Practice Address - Phone:501-725-8008
Practice Address - Fax:501-725-8009
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7662-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical