Provider Demographics
NPI:1497152771
Name:KENT, ANNETTE (LPC)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:
Last Name:KENT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4354 W 187TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-1872
Mailing Address - Country:US
Mailing Address - Phone:216-619-6194
Mailing Address - Fax:216-619-6195
Practice Address - Street 1:526 SUPERIOR AVE E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-1902
Practice Address - Country:US
Practice Address - Phone:216-619-6194
Practice Address - Fax:216-619-6195
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0600458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health