Provider Demographics
NPI:1073136255
Name:CUCCHERINI, KARA MARIE
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:CUCCHERINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 E PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2368
Mailing Address - Country:US
Mailing Address - Phone:804-285-9838
Mailing Address - Fax:804-285-9839
Practice Address - Street 1:2601 WILLARD RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-3638
Practice Address - Country:US
Practice Address - Phone:804-549-2376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000315106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst