Provider Demographics
NPI:1336207307
Name:DEMERCHANT, KENT D (MHRT II)
Entity type:Individual
Prefix:MR
First Name:KENT
Middle Name:D
Last Name:DEMERCHANT
Suffix:
Gender:M
Credentials:MHRT II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HATCH DR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-2159
Mailing Address - Country:US
Mailing Address - Phone:207-492-1653
Mailing Address - Fax:207-492-1633
Practice Address - Street 1:7 HATCH DR
Practice Address - Street 2:SUITE 290
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-2159
Practice Address - Country:US
Practice Address - Phone:207-492-1653
Practice Address - Fax:207-492-1633
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMHRT II101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor