Healthcare Provider Details

I. General information

NPI: 1780955054
Provider Name (Legal Business Name): KENT COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2012
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 GREENWAY SUITE 203
BALTIMORE MD
21218-2645
US

IV. Provider business mailing address

3405 GREENWAY SUITE 203
BALTIMORE MD
21218-2645
US

V. Phone/Fax

Practice location:
  • Phone: 410-662-9949
  • Fax:
Mailing address:
  • Phone: 410-662-9949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC3690
License Number StateMD

VIII. Authorized Official

Name: MR. JOHN A KENT
Title or Position: OWNER
Credential: LCPC
Phone: 410-662-9949