Provider Demographics
NPI:1134393341
Name:KENNEDY-PRESSEY, KERRY (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:KENNEDY-PRESSEY
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 HERITAGE PARK BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5674
Mailing Address - Country:US
Mailing Address - Phone:801-917-5564
Mailing Address - Fax:
Practice Address - Street 1:880 HERITAGE PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5676
Practice Address - Country:US
Practice Address - Phone:801-917-5564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
UT5998213-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical