Individual provider · Type 1 NPI

Shelly Marie Kennedy-Gonzalez, LPC

Mental Health Counselor · Broken Arrow, OK

NPI number 1679923320 Active

Practice location

2017 S Elm Pl Ste 104
Broken Arrow, OK 74012-7034

Call (918) 379-4431 Map

Fax (918) 328-2380

Mailing address

6931 S 66th East Ave Ste 200
Tulsa, OK 74133-1765

Other practice locations

  • 6931 S 66th East Ave Ste 200, Tulsa, OK 74133-1765 · (918) 379-4431

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X06888 (OK)
Counselor 101Y00000X6888 (OK)

Mental Health Counselor: Definition to come...

6 other providers at this address

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About NPI 1679923320

Shelly Marie Kennedy-Gonzalez, LPC's National Provider Identifier is 1679923320, issued on Jun 14, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Broken Arrow, OK. The record was last updated on Nov 8, 2025.