Provider Demographics
NPI:1427594647
Name:KUTNER THERAPY, AN INDIVIDUAL & FAMILY COUNSELING CORPORATION
Entity Type:Organization
Organization Name:KUTNER THERAPY, AN INDIVIDUAL & FAMILY COUNSELING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-607-8155
Mailing Address - Street 1:3333 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3808
Mailing Address - Country:US
Mailing Address - Phone:619-607-8155
Mailing Address - Fax:619-610-9287
Practice Address - Street 1:3333 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 215
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3808
Practice Address - Country:US
Practice Address - Phone:619-607-8155
Practice Address - Fax:619-610-9287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92589106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty