Healthcare Provider Details

I. General information

NPI: 1760775092
Provider Name (Legal Business Name): SERENA A KENT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 SW 29TH ST
TOPEKA KS
66614-2001
US

IV. Provider business mailing address

3135 SE STARLITE DR
TOPEKA KS
66605-2167
US

V. Phone/Fax

Practice location:
  • Phone: 785-329-6614
  • Fax:
Mailing address:
  • Phone: 785-817-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9229
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: