Healthcare Provider Details

I. General information

NPI: 1376308882
Provider Name (Legal Business Name): MARSHALL HENRY KUHN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 MEDICAL PARK
HATTIESBURG MS
39401-9080
US

IV. Provider business mailing address

282 STEELE RD
HATTIESBURG MS
39402-9058
US

V. Phone/Fax

Practice location:
  • Phone: 601-261-1650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3073
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: