Provider Demographics
NPI:1982297925
Name:LEFEBVRE, KENT (MA)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:LEFEBVRE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 LAKE LILY DR APT C441
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7613
Mailing Address - Country:US
Mailing Address - Phone:954-401-7452
Mailing Address - Fax:
Practice Address - Street 1:90 FOX RIDGE CT STE B
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-5001
Practice Address - Country:US
Practice Address - Phone:386-259-4514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22042101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health