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General NPI Number Information
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NPI Number | 1376526798
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Entity Type | Individual
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Provider Name | KATHY LEE KENT M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 319 E MADISON ST STE 2M
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City | SPRINGFIELD
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State | IL
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Zip | 62701-3122
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Country | US
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Telephone | 217-900-0040
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Fax | 217-331-1991
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Provider Business Mailing Address
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Address Line | 1217 OAKMONT DR
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City | SPRINGFIELD
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State | IL
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Zip | 62704-2122
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Country | US
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Telephone | 443-880-0808
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1140174
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.023504
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License Number State | IL
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