Individual
BRYCE KASUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC LADC
Contact information
Practice address
40 E BENEDICT AVE, HAVERTOWN, PA 19083-2402
(610) 212-3328
Mailing address
40 E BENEDICT AVE, HAVERTOWN, PA 19083-2402
(610) 212-3328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
165
CT
101YP2500X
Professional Counselor
Primary
PC002908
PA
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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