Provider Demographics
NPI:1578110961
Name:ROBERT A KUTNER PSYD AND ASSOCIATES PA
Entity Type:Organization
Organization Name:ROBERT A KUTNER PSYD AND ASSOCIATES PA
Other - Org Name:ROBERT A KUTNER PSYD AND ASSOCIATES PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:KUTNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:213-222-9197
Mailing Address - Street 1:3890 W ANN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-4416
Mailing Address - Country:US
Mailing Address - Phone:213-222-8197
Mailing Address - Fax:702-974-0821
Practice Address - Street 1:3890 W ANN RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-4416
Practice Address - Country:US
Practice Address - Phone:213-222-8197
Practice Address - Fax:702-974-0821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty