Healthcare Provider Details

I. General information

NPI: 1760315980
Provider Name (Legal Business Name): ALEKSEY ALEXANDER KUCHANSKIY PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 E LIBBY ST
PHOENIX AZ
85022-1252
US

IV. Provider business mailing address

1208 E LIBBY ST
PHOENIX AZ
85022-1252
US

V. Phone/Fax

Practice location:
  • Phone: 520-360-6757
  • Fax:
Mailing address:
  • Phone: 520-360-6757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number340469
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: