Provider Demographics
NPI:1609677236
Name:NINA KUCYK, PSYD
Entity type:Organization
Organization Name:NINA KUCYK, PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KUCYK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, PCC-S
Authorized Official - Phone:330-620-8519
Mailing Address - Street 1:2401 WHIPPLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1513
Mailing Address - Country:US
Mailing Address - Phone:330-620-8519
Mailing Address - Fax:330-956-5682
Practice Address - Street 1:2401 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1513
Practice Address - Country:US
Practice Address - Phone:330-620-8519
Practice Address - Fax:330-956-5682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health