Provider Demographics
NPI:1598940124
Name:KENNEDY, BETH BENATTI (MS, CAGS)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:BENATTI
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MS, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3756
Mailing Address - Country:US
Mailing Address - Phone:978-771-7170
Mailing Address - Fax:978-922-1957
Practice Address - Street 1:35 JAMES ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3756
Practice Address - Country:US
Practice Address - Phone:978-771-7170
Practice Address - Fax:978-922-1957
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1172106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist