Provider Demographics
NPI:1134612575
Name:KUKA, BRITTANY LYNN (LPC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNN
Last Name:KUKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:WI
Mailing Address - Zip Code:54891-0305
Mailing Address - Country:US
Mailing Address - Phone:715-504-0688
Mailing Address - Fax:715-504-0650
Practice Address - Street 1:1600 OMALLEY RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-7301
Practice Address - Country:US
Practice Address - Phone:907-349-2222
Practice Address - Fax:907-349-5335
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK126292101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional