Provider Demographics
NPI:1417036138
Name:KENT, NANCY M (MS, CRC, LPCS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:KENT
Suffix:
Gender:F
Credentials:MS, CRC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 WELLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7501
Mailing Address - Country:US
Mailing Address - Phone:919-475-7661
Mailing Address - Fax:
Practice Address - Street 1:515 WELLINGHAM DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7501
Practice Address - Country:US
Practice Address - Phone:919-475-7661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4589101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional