Kenneth Lamar Prust in Beaver Dam - Mental Health
Kenneth Lamar Prust - NPI 1134113178
Kenneth Lamar Prust is a Mental Health in Beaver Dam, Wisconsin. Kenneth Lamar Prust practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Kenneth Lamar Prust is 1134113178. The last update date is 2007-07-09.
Kenneth Lamar Prust's current location address is 1200 N Center St, Beaver Dam, Wisconsin. You can contact this provider via phone number 9208873171 and fax number 9208878662. The mailing address for Kenneth Lamar Prust is 1200 N Center St, Beaver Dam, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Lamar Prust |
|---|---|
| Address | 1200 N Center St, Beaver Dam, Wisconsin |
| Phone Number | 9208873171 |
| Fax Number | 9208878662 |
| Sole Proprietor | X |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1134113178 |
|---|---|
| Provider Enumeration Date | 2005-09-06 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 1200 N Center St |
|---|---|
| City | Beaver Dam |
| State | Wisconsin (WI) |
| Post Code | 539161148 |
| Phone Number | 9208873171 |
| Fax Number | 9208878662 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | 6795-123 |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 43579800 | WI | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kenneth Lamar Prust?
The Kenneth Lamar Prust has been issued the NPI (National Provider Identifier) 1134113178 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Kenneth Lamar Prust is physically located?
The Kenneth Lamar Prust is situated at the following address: 1200 N Center St, Beaver Dam, WI 539161148.
What is Kenneth Lamar Prust's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Kenneth Lamar Prust is Mental Health, and the taxonomy code that categorizes this field of expertise is 101Ym0800X.
On what date did Kenneth Lamar Prust receive its 1134113178 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Lamar Prust was assigned its 1134113178 on 2005-09-06, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Kenneth Lamar Prust, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Kenneth Lamar Prust, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-09.
NPI Number: 1356344279
Address: Mount St. Mary's Hospital Laboratory, Lewiston, NY