Individual
JOHN CHARLES KUEHNE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, ACADC
Contact information
Practice address
1276 W RIVER ST STE 100, BOISE, ID 83702-7083
(208) 338-4699
Mailing address
5223 N BACKWATER AVE, BOISE, ID 83714-1989
(208) 761-3937
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11720
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-24735
ID
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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