Kenneth David Kussin
Individual provider Active NPI School Psychologist · Murphysboro, IL
NPI 1003320243 · NPPES record last updated Nov 27, 2017
Key facts
- NPI
- 1003320243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 48 Conifer LN
Murphysboro, IL 62966-5242 - Phone
- (618) 559-3342
- Fax
- (618) 559-3342
- NPI assigned
- Nov 27, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
48 Conifer LN
Murphysboro, IL 62966-5242
Mailing address
48 Conifer LN
Murphysboro, IL 62966
Phone (618) 559-3342
Other providers in Murphysboro, IL
- Sherry Ann Kirkman
- Mary Ann Kohring
- Kroger Limited Partnership I
- Thomas William Kupferer
- Valerie Ann Kupferer
- Laboratory Corporation of America
- Elissa Gumiran Layson
- Peggy L Legan
- Stacey A Leithliter
- Lifenet, Inc.
All providers in Murphysboro, IL · School Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.