Kelley Kuchinov

Primary specialty

Art TherapistTaxonomy code 221700000X

Practice address

11250 Roger Bacon Dr Ste 301
Reston, VA 20190-5219

Phone

(209) 789-5788

NPI assigned

Jun 16, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560643200000",
    "number": "1639739303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20120 BANDON DUNES CT",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201477019",
            "telephone_number": "732-995-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11250 ROGER BACON DR STE 301",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905219",
            "telephone_number": "209-789-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHINOV",
        "first_name": "KELLEY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-16",
        "last_updated": "2019-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelley@sagehousearttherapy.com",
            "affiliation": "N",
            "address_1": "11250 Roger Bacon Dr Ste 301",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201905219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carmen Kresha, RD
• Matthew Ryan Krupa
• David M Kruse, MD
• Karen Ku, M.D.
• Priya Kucheria
• Ronald Stephan Kulik II, D.C.
• Neha Kumar, M.D.
• Rusne Kuzmickas, DPT
• Rachel Katherine Labella, PT, DPT
• Liliana Labonte, LPC

• Art Therapist in Reston, VA
• Providers in Reston, VA by specialty
• Art Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.