Provider Demographics
NPI:1043641863
Name:KIRSCHNER, BRENTON (LMFT)
Entity type:Individual
Prefix:
First Name:BRENTON
Middle Name:
Last Name:KIRSCHNER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203B WESTPORT DR
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3657
Mailing Address - Country:US
Mailing Address - Phone:501-843-9233
Mailing Address - Fax:501-843-9656
Practice Address - Street 1:203B WESTPORT DR
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3657
Practice Address - Country:US
Practice Address - Phone:501-843-9233
Practice Address - Fax:501-843-9656
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARM1510009106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist