Provider Demographics
NPI:1568437051
Name:HUNT, KENNETH L (LICSW)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:L
Last Name:HUNT
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:ST ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-1646
Mailing Address - Country:US
Mailing Address - Phone:802-524-0979
Mailing Address - Fax:
Practice Address - Street 1:107 FISHER POND RD
Practice Address - Street 2:
Practice Address - City:ST ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-6286
Practice Address - Country:US
Practice Address - Phone:802-524-6555
Practice Address - Fax:802-524-6562
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00002551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT356393OtherMHN
VT2031778OtherCIGNA
VTP00239533OtherRAILROAD MEDICARE
VT1007227Medicaid
VT233980OtherVALUE OPTIONS
VT28968OtherBCBS
VT356393OtherMHN