Individual
BRENT RICHARD IDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSCSW
Contact information
Practice address
1901 E 1ST ST, NEWTON, KS 67114-0467
(316) 284-6400
(316) 284-6490
Mailing address
PO BOX 467, 1901 E 1ST ST, NEWTON, KS 67114-0467
(316) 284-6400
(316) 284-6490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4374
KS
1041C0700X
Clinical Social Worker
7784
KS
Other
Enumeration date
07/09/2010
Last updated
10/27/2014
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