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Individual

DR. KEVIN LANCE CUFFEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ED.D

Contact information

Practice address
102 CAMEL BACK CT, SUFFOLK, VA 23434-1519
(757) 470-9044
Mailing address
102 CAMEL BACK CT, SUFFOLK, VA 23434-1519

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704012899
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102528
VA
101YM0800X
Mental Health Counselor
0701013070
VA
101YP2500X
Professional Counselor
0701013070
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83-0738194
VA
01
99-0580539
IRS
Enumeration date
03/13/2020
Last updated
02/09/2024
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