Provider Demographics
NPI:1861661688
Name:KIEHNA, JAMES STEPHEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:STEPHEN
Last Name:KIEHNA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14221 WALKERS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-9125
Mailing Address - Country:US
Mailing Address - Phone:704-588-0829
Mailing Address - Fax:
Practice Address - Street 1:1801 E 5TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2379
Practice Address - Country:US
Practice Address - Phone:704-588-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0019961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical