Provider Demographics
NPI:1376000604
Name:KUCHTA COUNSELING, INC.
Entity Type:Organization
Organization Name:KUCHTA COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:KUCHTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-358-8389
Mailing Address - Street 1:PO BOX 1234
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32402-1234
Mailing Address - Country:US
Mailing Address - Phone:850-358-8389
Mailing Address - Fax:850-541-9914
Practice Address - Street 1:814 GRACE AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2520
Practice Address - Country:US
Practice Address - Phone:850-358-8389
Practice Address - Fax:850-541-9914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)