Healthcare Provider Details

I. General information

NPI: 1841518529
Provider Name (Legal Business Name): NATALIE A. KUCENSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 ROUTE 22 STE 3D
BRIDGEWATER NJ
08807-2949
US

IV. Provider business mailing address

1065 ROUTE 22 STE 3D
BRIDGEWATER NJ
08807-2949
US

V. Phone/Fax

Practice location:
  • Phone: 908-231-0511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00406700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: