Provider Demographics
NPI:1962643320
Name:USRY, JAMES KENT (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:KENT
Last Name:USRY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLUMBUS AFB 201 INDEPENDENCE DR
Mailing Address - Street 2:14TH MEDICAL GROUP
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39710-0001
Mailing Address - Country:US
Mailing Address - Phone:662-434-1126
Mailing Address - Fax:
Practice Address - Street 1:COLUMBUS AFB 201 INDEPENDENCE DR
Practice Address - Street 2:14TH MEDICAL GROUP
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39710-0001
Practice Address - Country:US
Practice Address - Phone:662-434-1126
Practice Address - Fax:662-434-2246
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical