RICHARD C. KENNERLY (NPI# 1992959761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992959761 |
| Entity Type | Individual |
| Full Name | RICHARD C. KENNERLY |
| Credential | PH.D. |
| Practice Address |
170 Davidson Hwy Ste 201 Concord NC 28027-4255 |
| Mailing Address |
170 Davidson Hwy Ste 106 Concord NC 28027-4246 |
| Practice Telephone | 7046593541 |
| Practice Fax Number | 8889773202 |
| Mailing Telephone | 7046593541 |
| Mailing Fax Number | 8889773202 |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2019-12-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | PSY 22288 | CA | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | 4561 | NC | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | PSY 22288 | CA | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 4561 | NC | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
4561 | NC | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY22288 | CA | Behavioral Health & Social Service Providers |
| Street Address |
170 DAVIDSON HWY STE 201 |
| City | CONCORD |
| State | NC |
| Zip Code | 28027-4255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922630979 | Sandra Kay Starr | Counselor | 170 Davidson Hwy Ste 201, Concord, NC 28027-4255 | 2020-02-07 |
| 1760021471 | Harriett Elizabeth Moore Payne | Counselor | 170 Davidson Hwy Ste 201, Concord, NC 28027-4255 | 2019-12-27 |
| 1881231942 | Ilse Sucely De Leon | Counselor | 170 Davidson Hwy Ste 201, Concord, NC 28027-4255 | 2019-12-06 |
| 1114582517 | Lacee Overcash Jacobs | Counselor | 170 Davidson Hwy Ste 201, Concord, NC 28027-4255 | 2019-05-01 |
| 1992282800 | Sara Hillman Brown | Counselor | 170 Davidson Hwy Ste 201, Concord, NC 28027-4255 | 2018-07-24 |
| 1487188397 | Natalie Atwell/concord Counseling Associates | Counselor | 170 Davidson Hwy Ste 201, Concord, NC 28027-4255 | 2017-04-18 |
| 1720308729 | Natalie R Atwell | Counselor | 170 Davidson Hwy Ste 201, Concord, NC 28027-4255 | 2010-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023652252 | Medcare Transport of Nc | Non-emergency Medical Transport (VAN) | 7039 Northwinds Dr Nw, Unit C, Concord, NC 28027 | 2019-10-31 |
| 1538718770 | Carolyn Ann Broadnax | Technician | 3524 Cedar Springs Dr, Concord, NC 28027 | 2019-09-10 |
| 1447806575 | Claire-ann E Papp | Dentist | 8815 Christenbury Parkway, Suite 40, Concord, NC 28027 | 2019-08-14 |
| 1578120218 | Philip Osborn | Dentist | 5408 Nc-49, Harrisburg, NC 28027 | 2019-05-28 |
| 1639648306 | Kristen Morris Spell | Counselor | 195 Lower Cape Dr Sw Apt 107, Concord, NC 28027 | 2018-11-25 |
| 1568959625 | Laurie Ford | Counselor | 705 Samuel Adams Cir Sw, Concord, NC 28027 | 2018-04-15 |
| 1598278194 | Autumn Nobles | Specialist/Technologist | 10193 Falling Leaf Dr Nw, Concord, NC 28027 | 2017-11-06 |
| 1386192938 | Brundasudha Satti IIi | Physical Therapist | 379 Sutoforest Dr Nw, Concord, NC 28027 | 2016-09-12 |
| 1467809616 | Kathryn Teal Watts | Dentist | 5305345 Vining St Nw, #201, Concord, NC 28027 | 2016-05-18 |
| 1720443849 | Denette Carte | Health Educator | 9712 Ravenscroft Lane Nw, Concord, NC 28027 | 2015-12-16 |
| Find all providers in zip 28027 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912217324 | Rebecca Tubbs | Clinical Neuropsychologist | 9 Pond Ln Ste 3c, Concord, MA 01742-2863 | 2010-10-19 |
| 1770624223 | Renee Cutiongco Folsom | Clinical Neuropsychologist | 86 Baker Avenue Ext Ste 301, Concord, MA 01742-2132 | 2007-02-09 |
| 1538141825 | Nancy Ann Lundy | Clinical Neuropsychologist | 40 Potter St, Concord, MA 01742-3510 | 2005-11-14 |
| 1346841418 | Rebecca Tubbs Psyd Pllc | Clinical Neuropsychologist | 9 Pond Ln Ste 3c, Concord, MA 01742-2863 | 2020-11-05 |
| 1548704190 | Allison Schettini Evans, Phd | Clinical Neuropsychologist | 747 Main St, Suite 307, Concord, MA 01742-3302 | 2016-12-15 |
| 1164730420 | Susan R Mcgurk | Clinical Neuropsychologist | 105 Pleasant St, Dartmouth Psychiatric Research Center, Main Building, Concord, NH 03301-3852 | 2010-09-21 |
| 1659506269 | Brian W Ablitz | Clinical Neuropsychologist | 487 Lake Concord Rd Ne, Concord, NC 28025-2934 | 2009-05-27 |
| 1356510960 | Susan D. Downing | Clinical Neuropsychologist | 9 Pond Ln, Damonmill Square, Suite 3-1a, Concord, MA 01742-2858 | 2008-02-27 |
| 1497965370 | Laura Elizabeth Benkov | Clinical Neuropsychologist | 56 Winthrop St, Concord, MA 01742-2076 | 2007-05-22 |
| 1184753824 | John Thomas Capuco | Clinical Neuropsychologist | 254 Pleasant St, Concord, NH 03301-2551 | 2007-03-05 |
| Find all providers in CONCORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.