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Individual

KENNETH A STREET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
3413 RAINBOW PKWY STE A, RAINBOW CITY, AL 35906-3234
(256) 490-6423
(256) 380-5857
Mailing address
3413 RAINBOW PKWY STE A, RAINBOW CITY, AL 35906-3234
(256) 490-6423
(256) 380-5857

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2004
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2004
LPC
AL
Enumeration date
08/02/2005
Last updated
01/09/2025
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