Organization Active NPI

Steven B. Kutash, Psy.D., PLLC

  • Clinical Psychologist
  • Fort Collins, CO
National Provider Identifier
1306233721
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
STEVEN B. KUTASH, PSY.D., PLLC
Practice address
1030 Centre Ave
Suite B
Fort Collins, CO 80526-1849
Phone
(970) 568-6323
Fax
(970) 305-8322
NPI assigned
Apr 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steven Brant Kutash, PSY.D.NPI 1326272816
Title
Managing Member
Phone
(970) 568-6323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1030 Centre Ave
Suite B
Fort Collins, CO 80526-1849

Mailing address

1030 Centre Ave
Suite B
Fort Collins, CO 80526-1849
Phone (970) 568-6323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151001000422 CO Part B Supplier - Clinic/Group Practice 3173831773 Receives reassigned benefits from 1 practitioner
Practice locations: Longmont, CO

National Provider Directory

National Provider Directory

Locations

1030 Centre Ave
Ste B
Fort Collins, CO 80526
Phone (406) 544-2307

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1306233721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 CENTRE AVE",
            "address_2": "SUITE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261849",
            "telephone_number": "970-568-6323",
            "fax_number": "970-305-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 CENTRE AVE",
            "address_2": "SUITE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261849",
            "telephone_number": "970-568-6323",
            "fax_number": "970-305-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN B. KUTASH, PSY.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "KUTASH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "BRANT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "970-568-6323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.