Provider Demographics
NPI:1700354651
Name:LENHARDT, KENNETH ERIC (MSW)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:ERIC
Last Name:LENHARDT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HIGASHI KUSABUKA CHO 4-8, 2ND FLOOR
Mailing Address - Street 2:AOI KU
Mailing Address - City:SHIZUOKA CITY
Mailing Address - State:SHIZUOKA KEN
Mailing Address - Zip Code:4200865
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HIGASHI KUSABUKA CHO 4-8, 2ND FLOOR
Practice Address - Street 2:AOI KU
Practice Address - City:SHIZUOKA CITY
Practice Address - State:SHIZUOKA KEN
Practice Address - Zip Code:4200865
Practice Address - Country:JP
Practice Address - Phone:054-340-0700
Practice Address - Fax:054-340-0700
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0187131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty