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Individual

ELIZABETH J KENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
3200 MACCORKLE AVE SE, FL 5, CHARLESTON, WV 25304-1297
(304) 388-1000
(304) 388-1021
Mailing address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 647-6006

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00454379
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001712478
MS BCBS
WV
05
3810006566
WV
01
4268833
AETNA
WV
Enumeration date
09/20/2006
Last updated
08/11/2023
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