Provider Demographics
NPI:1255512208
Name:KENT, WENDY P (MA, LADC1)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:P
Last Name:KENT
Suffix:
Gender:F
Credentials:MA, LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 UNION ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1310
Mailing Address - Country:US
Mailing Address - Phone:781-581-9270
Mailing Address - Fax:781-346-6369
Practice Address - Street 1:181 UNION ST
Practice Address - Street 2:SUITE B
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1310
Practice Address - Country:US
Practice Address - Phone:781-581-9270
Practice Address - Fax:781-346-6369
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)