Healthcare Provider Details

I. General information

NPI: 1316580186
Provider Name (Legal Business Name): COREY RAE KUHN PH. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 DELAWARE ST STE 9
LEAVENWORTH KS
66048-2664
US

IV. Provider business mailing address

1887 WHITNEY MESA DR STE 1221
HENDERSON NV
89014-2069
US

V. Phone/Fax

Practice location:
  • Phone: 702-550-9079
  • Fax: 833-334-0273
Mailing address:
  • Phone: 702-550-9079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License NumberPY0974
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0974
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: