Healthcare Provider Details

I. General information

NPI: 1730398983
Provider Name (Legal Business Name): ALISON KUCHTA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 NORTH ST SUITE 102
DANBURY CT
06810-5609
US

IV. Provider business mailing address

70 NORTH ST SUITE 102
DANBURY CT
06810-5609
US

V. Phone/Fax

Practice location:
  • Phone: 203-216-5958
  • Fax:
Mailing address:
  • Phone: 203-216-5958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number006355
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: