Kennedy Lake is a Mount Pleasant, Wisconsin based therapist who is specialized in Occupational Therapy. Active license number of Kennedy Lake is 9045 for Occupational Therapy in Wisconsin. current practice location is 13250 Washington Ave, Mount Pleasant. Patients can reach at 262-799-8330. Kennedy Lake NPI number (Unique professional ID assigned by NPPES) is 1679435408.
Kennedy Lake provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction.
Complete Profile:
Kennedy Lake speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Kennedy Lake |
| Specialization: | Occupational Therapy |
| Gender: | X |
| Practice Address: | 13250 Washington Ave, Mount Pleasant,
Wisconsin, 53177-1516 |
| Phone: | 262-799-8330 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1679435408 |
| NPI Enumeration Date: | 01 Dec, 2025 |
| NPI Last Update On: | 23 Dec, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kennedy Lake are as mentioned below.
| License Number | Specialization | State | Status | |
| 9045 | Occupational Therapy | Wisconsin | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Kennedy Lake such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 100390531 | Medicaid | Wisconsin | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kennedy Lake
Po Box 735044,
Chicago, Illinois |
| Zip: | 60673-5044 |
| Phone Number: | 800-326-2250 |
Patients can reach Kennedy Lake at
13250 Washington Ave, Mount Pleasant, Wisconsin or can
call to book an appointment on 262-799-8330.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 March, 2026.