Healthcare Provider Details

I. General information

NPI: 1982158432
Provider Name (Legal Business Name): BRENT DANIEL RICE MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2016
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 E INDIANA ST STE 103
EVANSVILLE IN
47715-7448
US

IV. Provider business mailing address

1100 WALNUT ST
OWENSBORO KY
42301-2956
US

V. Phone/Fax

Practice location:
  • Phone: 216-468-5000
  • Fax:
Mailing address:
  • Phone: 270-689-6500
  • Fax: 270-689-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34009906A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: