Basic Information
| Provider Information | |||||||||
| NPI: | 1922542299 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUGLER | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 COMMUNITY | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 647358804 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1278 W US HIGHWAY 40 | ||||||||
| Address2: | |||||||||
| City: | ODESSA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640769612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8448538937 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2016 | ||||||||
| LastUpdateDate: | 12/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2019045185 | MO | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101Y00000X | E.1901421 | OH | N | Behavioral Health & Social Service Providers | Counselor |
No ID Information.