Healthcare Provider Details

I. General information

NPI: 1487640454
Provider Name (Legal Business Name): KENNETH KUHN MS, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 04/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N 2ND ST STE 304
ST CHARLES IL
60174-1853
US

IV. Provider business mailing address

311 N 2ND ST STE 304
ST CHARLES IL
60174-1853
US

V. Phone/Fax

Practice location:
  • Phone: 630-377-5105
  • Fax: 630-501-8403
Mailing address:
  • Phone: 630-377-5105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166000549
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: