Provider Demographics
NPI:1326183674
Name:KENT SUSSEX COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:KENT SUSSEX COMMUNITY SERVICES, INC.
Other - Org Name:KENT SUSSEX COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WALTON
Authorized Official - Last Name:PARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCMH
Authorized Official - Phone:302-735-7790
Mailing Address - Street 1:1241 COLLEGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-8713
Mailing Address - Country:US
Mailing Address - Phone:302-735-7790
Mailing Address - Fax:302-735-3654
Practice Address - Street 1:1241 COLLEGE PARK DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8713
Practice Address - Country:US
Practice Address - Phone:302-735-7790
Practice Address - Fax:302-735-3654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE103TP2701X
DECL0001261QM2800X
DECL0123261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000022527Medicaid
DE0000465151Medicaid