Provider Demographics
NPI:1356403216
Name:KENT, DAVID SWORDS (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SWORDS
Last Name:KENT
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 1:1040 W ESCALON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-2015
Mailing Address - Country:US
Mailing Address - Phone:559-439-7815
Mailing Address - Fax:
Practice Address - Street 1:1040 W ESCALON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-2015
Practice Address - Country:US
Practice Address - Phone:559-439-7815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS127081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02195Medicare UPIN