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General NPI Number Information
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NPI Number | 1508844135
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Entity Type | Individual
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Provider Name | JOHN G KUTINAC JR. MA PA LPCC
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Gender | Male
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1155 S TELSHOR BLVD STE 200
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City | LAS CRUCES
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State | NM
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Zip | 88011-1009
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Country | US
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Telephone | 505-522-8002
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Fax | 505-522-8027
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Provider Business Mailing Address
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Address Line | 1155 S TELSHOR BLVD STE 200
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City | LAS CRUCES
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State | NM
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Zip | 88011-1009
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Country | US
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Telephone | 505-522-8002
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Fax | 505-522-8027
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PA9501
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1157
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License Number State | NM
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