Provider Demographics
NPI:1992390801
Name:KENNEDY, ASHLEY CELLER (MA, LMFT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CELLER
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1031
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91012-1031
Mailing Address - Country:US
Mailing Address - Phone:323-683-2802
Mailing Address - Fax:
Practice Address - Street 1:411 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-2815
Practice Address - Country:US
Practice Address - Phone:323-683-2802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist