Provider Demographics
NPI:1063556090
Name:WEBB, KENT E (LCSW)
Entity type:Individual
Prefix:MR
First Name:KENT
Middle Name:E
Last Name:WEBB
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 S CHERRY ST
Mailing Address - Street 2:SUITE 918
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2699
Mailing Address - Country:US
Mailing Address - Phone:303-394-4910
Mailing Address - Fax:303-759-3164
Practice Address - Street 1:950 S CHERRY ST
Practice Address - Street 2:SUITE 918
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2699
Practice Address - Country:US
Practice Address - Phone:303-394-4910
Practice Address - Fax:303-759-3164
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9840801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO550078Medicare ID - Type Unspecified