Provider Demographics
NPI:1306233721
Name:STEVEN B. KUTASH, PSY.D., PLLC
Entity type:Organization
Organization Name:STEVEN B. KUTASH, PSY.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BRANT
Authorized Official - Last Name:KUTASH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:970-568-6323
Mailing Address - Street 1:1030 CENTRE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1849
Mailing Address - Country:US
Mailing Address - Phone:970-568-6323
Mailing Address - Fax:970-305-8322
Practice Address - Street 1:1030 CENTRE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1849
Practice Address - Country:US
Practice Address - Phone:970-568-6323
Practice Address - Fax:970-305-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty