Individual
CAROLYN ELIZABETH KUCHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
4505 SHIRLEY GATE RD, FAIRFAX, VA 22030-5522
(703) 352-2205
Mailing address
4505 SHIRLEY GATE RD, FAIRFAX, VA 22030-5522
(703) 352-2205
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0701004756
VA
101YP2500X
Professional Counselor
Primary
0701004756
VA
106H00000X
Marriage & Family Therapist
0701004756
VA
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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