Healthcare Provider Details

I. General information

NPI: 1134612575
Provider Name (Legal Business Name): BRITTANY LYNN KUKA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W OMAHA ST
WASHBURN WI
54891-4557
US

IV. Provider business mailing address

PO BOX 305
WASHBURN WI
54891-0305
US

V. Phone/Fax

Practice location:
  • Phone: 715-504-0688
  • Fax: 715-504-0650
Mailing address:
  • Phone: 715-504-0688
  • Fax: 715-504-0650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7298-125
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7298-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: