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KENNADY LAKE AAC, CPC
NPI 1619747649
Peer Specialist in Longview, WA

Active since January 02, 2024
1400 COMMERCE AVE, LONGVIEW, WA 98632(360) 998-2047(360) 200-6736 Get Directions Write a Review

NPPES record last updated: January 2, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kennady Lake Aac, Cpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNADY LAKE AAC, CPC (NPI 1619747649) is an individual peer specialist in Longview, Washington, licensed in Washington (CG61505391) and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1619747649
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKENNADY LAKECredential: AAC, CPC
Location Address1400 COMMERCE AVELongview, WA 98632-3756
Mailing AddressPo Box 2394Longview, WA 98632-8455 · (360) 200-5419 · Fax (360) 200-6736
Phone(360) 998-2047
Fax(360) 200-6736
Sole ProprietorNo
Enumeration DateJanuary 2, 2024
NPPES CertifiedJanuary 2, 2024
✔ NPI 1619747649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in WA · CG61505391
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
1400 COMMERCE AVE, Longview, WA 98632
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KHARECE TEVIS CADWELL BS, R-AAC
Counselor
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 200-5419
LIAMARA BULLOCK
Counselor
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 998-2047
NIA T FITZPATRICK CPC
Peer Specialist
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 998-2047
CASSIE N HALL
Peer Specialist
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 998-2047
RACHEL RASUMUSSEN AAC, CPC
Peer Specialist
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 998-2047
KELSEY TRICKLER
Peer Specialist
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 998-2047
TIERRA MAKENZIE COALMAN R-AAC, CPC
Peer Specialist
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 998-2047
KATELAN CERDENA BS, AAC
Counselor
1400 COMMERCE AVE
LONGVIEW, WA 98632
Cowlitz County (360) 998-2047

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennady Lake's NPI number?

The NPI number for Kennady Lake is 1619747649. It was assigned to this individual provider in the NPPES registry on January 2, 2024.

Where is Kennady Lake located?

Kennady Lake practices at 1400 Commerce Ave, Longview, WA 98632. The listed phone number is (360) 998-2047.

What is Kennady Lake's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kennady Lake was last updated on January 2, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.