Provider Demographics
NPI:1144324781
Name:KENT, KAREN SUE (LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:KENT
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4808 FLORIST ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-3308
Mailing Address - Country:US
Mailing Address - Phone:940-322-3203
Mailing Address - Fax:940-322-8325
Practice Address - Street 1:2014 KELL BLVD STE C
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5584
Practice Address - Country:US
Practice Address - Phone:940-322-3203
Practice Address - Fax:940-322-8325
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10824101YP2500X
TX3678106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2221LCOtherBLUE CROSS/BLUE SHIELD