Provider Demographics
NPI:1124264072
Name:KUHN, CARISSA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:LYNN
Last Name:KUHN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11220 ELM LN
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0715
Mailing Address - Country:US
Mailing Address - Phone:704-426-3266
Mailing Address - Fax:704-943-0758
Practice Address - Street 1:11220 ELM LN
Practice Address - Street 2:SUITE 203
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-0715
Practice Address - Country:US
Practice Address - Phone:704-426-3266
Practice Address - Fax:704-943-0758
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6980101YP2500X
NC21473101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)