| Joshua M Kent, Licsw | |
|
5009 Excelsior Blvd Suite 134 St. Louis Park MN 55416 | |
| (612) 360-5685 | |
| (952) 285-4103 |
| Full Name | Joshua M Kent, Licsw |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 5009 Excelsior Blvd, St. Louis Park, Minnesota |
| Authorized Official Name and Position | Joshua M Kent (LICSW) |
| Authorized Official Contact | 6512640260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua M Kent, Licsw 5009 Excelsior Blvd Suite 134 St. Louis Park MN 55416 Ph: (612) 360-5685 | Joshua M Kent, Licsw 5009 Excelsior Blvd Suite 134 St. Louis Park MN 55416 Ph: (612) 360-5685 |
| NPI Number | 1629108410 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629108410 | NPI | - | NPPES |
| 607649100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 15118 (Minnesota) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 15118 (Minnesota) | Secondary |
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