Provider Demographics
NPI:1164654182
Name:BRAND, KENT ROY (LCSW, PIP)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:ROY
Last Name:BRAND
Suffix:
Gender:M
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 N SEMINARY ST
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-4688
Mailing Address - Country:US
Mailing Address - Phone:256-766-5707
Mailing Address - Fax:256-765-3888
Practice Address - Street 1:416 N SEMINARY ST
Practice Address - Street 2:SUITE 2100
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4688
Practice Address - Country:US
Practice Address - Phone:256-766-5707
Practice Address - Fax:256-765-3888
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSW-1858C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health