Provider Demographics
NPI:1912266750
Name:KUHAGEN, JAMES ALLAN (PH D)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLAN
Last Name:KUHAGEN
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6027 20TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3403
Mailing Address - Country:US
Mailing Address - Phone:703-534-8070
Mailing Address - Fax:
Practice Address - Street 1:6027 20TH ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3403
Practice Address - Country:US
Practice Address - Phone:703-534-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000511101YP2500X
VA1-01-0401103K00000X
VA0811000982103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1-01-0401OtherBOARD CERTIFIED BEHAVIOR ANALYST-D
VA0811000982OtherLICENSED APPLIED PSYCHOLOGIST
VA0701000511OtherLICENSED PROFESSIONAL COUNSELOR