Healthcare Provider Details

I. General information

NPI: 1548531023
Provider Name (Legal Business Name): ELIZABETH A KUHN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2012
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7727 BELOFF CT
THREE LAKES WI
54562-9280
US

IV. Provider business mailing address

7727 BELOFF CT
THREE LAKES WI
54562-9280
US

V. Phone/Fax

Practice location:
  • Phone: 715-937-3421
  • Fax:
Mailing address:
  • Phone: 715-937-3421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number128520-121
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8241-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: