Provider Demographics
NPI:1497300875
Name:KENT, ROBERT E (LADAC II)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:KENT
Suffix:
Gender:M
Credentials:LADAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 PARMLEY LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2614
Mailing Address - Country:US
Mailing Address - Phone:615-300-0036
Mailing Address - Fax:
Practice Address - Street 1:417 PARMLEY LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2614
Practice Address - Country:US
Practice Address - Phone:615-300-0036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDC0000000940101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)