Provider Demographics
NPI:1396333977
Name:HUTCHINSON, KALA JUNE (LPC, CAADC)
Entity type:Individual
Prefix:
First Name:KALA
Middle Name:JUNE
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:KALA
Other - Middle Name:JUNE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1916 TREMBLEY DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49749-9545
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1916 TREMBLEY DR
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-9545
Practice Address - Country:US
Practice Address - Phone:231-268-9583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-04915101YA0400X
MI6401222710101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty