Provider Demographics
NPI:1144530908
Name:KENT, CHARLEE M (LCPC)
Entity type:Individual
Prefix:MRS
First Name:CHARLEE
Middle Name:M
Last Name:KENT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:CHARLEE
Other - Middle Name:M
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:261 FRENCH ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5014
Mailing Address - Country:US
Mailing Address - Phone:207-819-8965
Mailing Address - Fax:
Practice Address - Street 1:179 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4365
Practice Address - Country:US
Practice Address - Phone:207-617-6713
Practice Address - Fax:207-217-6722
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL3727101YP2500X
MECC4277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional