MEDICARE: MR. KEN W KUSCHEL MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2002026260	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11408272	OTHER	MO	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306837604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEN W KUSCHEL MA, LPC

Provider Business Mailing Address
First Line	:	711 CRESTVIEW DR
Second Line	:
City	:	MONETT
State	:	MO
Zip	:	65708-1510
Country	:	US
Telephone Number	:	417-229-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 S MADISON AVE
Second Line	:
City	:	AURORA
State	:	MO
Zip	:	65605-1427
Country	:	US
Telephone Number	:	417-678-6233
Fax Number	:	417-847-1765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	09/25/2023

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