Provider Demographics
NPI:1679220735
Name:KUHL, ALLYSSAN MARIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ALLYSSAN
Middle Name:MARIE
Last Name:KUHL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 BRIGHTON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2810
Mailing Address - Country:US
Mailing Address - Phone:718-552-5922
Mailing Address - Fax:
Practice Address - Street 1:164 BRIGHTON AVE APT 1
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2810
Practice Address - Country:US
Practice Address - Phone:718-552-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102677104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty