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General NPI Number Information
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NPI Number | 1881071488
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Entity Type | Individual
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Provider Name | JEFFREY KILHAM CUBETA LPC, CC, MS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 4130 HUNT PL NE
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City | WASHINGTON
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State | DC
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Zip | 20019-3565
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Country | US
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Telephone | 202-388-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 6629 VAN WINKLE DR
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City | FALLS CHURCH
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State | VA
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Zip | 22044-1011
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Country | US
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Telephone | 703-447-8345
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGPC00032
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PRC14891
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License Number State | DC
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