Provider Demographics
NPI:1700214053
Name:BELGRAVE, KENT (LMSW)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:BELGRAVE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2907
Mailing Address - Country:US
Mailing Address - Phone:914-737-7338
Mailing Address - Fax:
Practice Address - Street 1:1101 MAIN ST
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566
Practice Address - Country:US
Practice Address - Phone:914-737-7338
Practice Address - Fax:914-736-0921
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker