Provider Demographics
NPI:1043228331
Name:KUHN, MARY THERESE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:THERESE
Last Name:KUHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 W FAYETTE ST
Mailing Address - Street 2:SUITE 418
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-1275
Mailing Address - Country:US
Mailing Address - Phone:315-471-4120
Mailing Address - Fax:
Practice Address - Street 1:327 W FAYETTE ST
Practice Address - Street 2:SUITE 418
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-1275
Practice Address - Country:US
Practice Address - Phone:315-471-4120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR024799-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55871BMedicare ID - Type Unspecified