Provider Demographics
NPI:1912553710
Name:KATY KUCHTA, LLC
Entity Type:Organization
Organization Name:KATY KUCHTA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MA , LCMHC
Authorized Official - Phone:802-535-4422
Mailing Address - Street 1:227 KITTREDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:BARTON
Mailing Address - State:VT
Mailing Address - Zip Code:05822
Mailing Address - Country:US
Mailing Address - Phone:802-535-4422
Mailing Address - Fax:
Practice Address - Street 1:227 KITTREDGE RD
Practice Address - Street 2:
Practice Address - City:BARTON
Practice Address - State:VT
Practice Address - Zip Code:05822-9587
Practice Address - Country:US
Practice Address - Phone:802-535-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1033881Medicaid