Provider Demographics
NPI:1639181282
Name:MASSIE, KENT B (LPC)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:B
Last Name:MASSIE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 CANTRELL AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3248
Mailing Address - Country:US
Mailing Address - Phone:540-564-5960
Mailing Address - Fax:540-433-4338
Practice Address - Street 1:752 OTT ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3214
Practice Address - Country:US
Practice Address - Phone:540-564-5960
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003890101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010255058Medicaid
VA191486OtherANTHEM PROVIDER NUMBER
VA089892MOtherSENTARA PROVIDER NUMBER
VA1164637518OtherGROUP NPI NUMBER
VA2275355OtherCIGNA
VAC05754OtherMEDICARE GROUP NUMBER
VA11716651OtherCAQH PROVIDER NUMBER