Healthcare Provider Details

I. General information

NPI: 1912266750
Provider Name (Legal Business Name): JAMES ALLAN KUHAGEN PH. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 05/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6027 20TH ST N
ARLINGTON VA
22205-3403
US

IV. Provider business mailing address

6027 20TH ST N
ARLINGTON VA
22205-3403
US

V. Phone/Fax

Practice location:
  • Phone: 703-534-8070
  • Fax:
Mailing address:
  • Phone: 703-534-8070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701000511
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-01-0401
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number0811000982
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: