Provider Demographics
NPI:1770812505
Name:KUEHN, SCOTT C (CSAC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:C
Last Name:KUEHN
Suffix:
Gender:M
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 OLD ABE RD
Mailing Address - Street 2:
Mailing Address - City:LAC DU FLAMBEAU
Mailing Address - State:WI
Mailing Address - Zip Code:54538-9386
Mailing Address - Country:US
Mailing Address - Phone:715-588-3371
Mailing Address - Fax:715-588-2031
Practice Address - Street 1:129 OLD ABE RD
Practice Address - Street 2:
Practice Address - City:LAC DU FLAMBEAU
Practice Address - State:WI
Practice Address - Zip Code:54538-9386
Practice Address - Country:US
Practice Address - Phone:715-588-3371
Practice Address - Fax:715-588-2031
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16113-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI16113-132OtherCSAC