Provider Demographics
NPI:1275810947
Name:KENT, GARY (LCPC, LAC, NCC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:KENT
Suffix:
Gender:M
Credentials:LCPC, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 MOUNTAIN TIMBERS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-8620
Mailing Address - Country:US
Mailing Address - Phone:406-892-1392
Mailing Address - Fax:
Practice Address - Street 1:285 2ND AVENUE WEST N
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3910
Practice Address - Country:US
Practice Address - Phone:406-890-2570
Practice Address - Fax:406-314-6186
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT726101YA0400X
MT274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)