Healthcare Provider Details

I. General information

NPI: 1114414349
Provider Name (Legal Business Name): ARIS KUNTZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4339 WINSTON AVE
COVINGTON KY
41015-1739
US

IV. Provider business mailing address

4339 WINSTON AVE
COVINGTON KY
41015-1739
US

V. Phone/Fax

Practice location:
  • Phone: 859-835-2573
  • Fax: 859-627-6327
Mailing address:
  • Phone: 859-835-2573
  • Fax: 859-627-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number256979
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: