Healthcare Provider Details

I. General information

NPI: 1699919142
Provider Name (Legal Business Name): KUZMICH FAMILY COUNSELING, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 MORRISS RD SUITE 110A
FLOWER MOUND TX
75028-3989
US

IV. Provider business mailing address

6021 MORRISS RD SUITE 110A
FLOWER MOUND TX
75028-3989
US

V. Phone/Fax

Practice location:
  • Phone: 972-754-7308
  • Fax: 972-591-5603
Mailing address:
  • Phone: 972-754-7308
  • Fax: 972-591-5603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16776
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number200885
License Number StateTX

VIII. Authorized Official

Name: DR. MOLLY M ARNOLD
Title or Position: DIRECTOR
Credential: PHD, LPCS, LMFT, RPT
Phone: 972-754-7308