Shianne Brent, LCSW

Individual provider Active NPI Clinical Social Worker · Fort Knox, KY

NPI 1659736742 · NPPES record last updated Dec 11, 2023

Key facts

NPI
1659736742
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
252683 (KY)
Practice address
200 Brule St
Fort Knox, KY 40121-6100
Phone
(502) 626-9881
Fax
(502) 626-6140
NPI assigned
Dec 16, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
164828KYMDAddiction (Substance Use Disorder) Counselor
252683KYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 164828 KY
Clinical Social Worker 1041C0700X 252683 KY Yes

Addresses

Primary practice location

200 Brule St
Fort Knox, KY 40121-6100

Mailing address

200 Brule St
Fort Knox, KY 40121-6100
Phone (270) 900-0373

Other providers in Fort Knox, KY

All providers in Fort Knox, KY · Clinical Social Worker in Kentucky

Sources for this page

Verify at the official NPI Registry.