Individual
KELLY P MUCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1112 US HIGHWAY 41, SCHERERVILLE, IN 46375-1361
(219) 613-0332
Mailing address
4524 WHITCOMB ST, GARY, IN 46408-3506
(219) 613-0332
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
1041S0200X
School Social Worker
—
—
Other
Enumeration date
06/27/2011
Last updated
04/23/2016
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