Provider Demographics
NPI:1801611264
Name:KENT, JAMES EDWIN (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWIN
Last Name:KENT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4360 SHORE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2994
Mailing Address - Country:US
Mailing Address - Phone:757-251-0879
Mailing Address - Fax:
Practice Address - Street 1:4360 SHORE DR STE 101
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2994
Practice Address - Country:US
Practice Address - Phone:757-251-0879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional