Healthcare Provider Details

I. General information

NPI: 1427429562
Provider Name (Legal Business Name): KEVIN CUCHIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2015
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 25TH AVE N STE 601
NASHVILLE TN
37203-1606
US

IV. Provider business mailing address

1109 WOODLAND ST UNIT 60644
NASHVILLE TN
37206-2883
US

V. Phone/Fax

Practice location:
  • Phone: 615-314-6788
  • Fax:
Mailing address:
  • Phone: 615-314-6788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6963
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: