DR. LINDA KUKUK HAUBOLD (NPI# 1649303454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649303454 |
| Entity Type | Individual |
| Full Name | DR. LINDA KUKUK HAUBOLD |
| Other Name | DR. LINDA SUSAN KUKUK |
| Credential | PHD |
| Practice Address |
1139 E Front St Traverse City MI 49686 |
| Mailing Address |
3045 Ojibwa Trail Traverse City MI 49686 |
| Practice Telephone | 2319477082 |
| Practice Fax Number | 2319471911 |
| Mailing Telephone | 2319477082 |
| Mailing Fax Number | 2319471911 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
6301008535 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS BS | 680B83299 | 01 |
| Street Address |
1139 E FRONT ST |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851424766 | Robert Louis Haubold | Psychologist | 1139 E Front St, Traverse City, MI 49686 | 2007-03-13 |
| 1427181239 | Dr Kukuk & Dr Haubold PC | Psychologist | 1139 E Front St, Traverse City, MI 49686 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922434281 | Samuel George Sarns | Psychologist | 3301 Veterans Dr Ste 126, Traverse City, MI 49684-4564 | 2013-09-18 |
| 1255585436 | Lori Boothroyd | Psychologist | 12935 S West Bay Shore Dr, Suite 200, Traverse City, MI 49684-6298 | 2008-11-14 |
| 1437324191 | Paul Edward Kaschel Jr. | Psychologist | 954 Business Park Dr Ste 5, Traverse City, MI 49686-8763 | 2008-04-24 |
| 1851424766 | Robert Louis Haubold | Psychologist | 1139 E Front St, Traverse City, MI 49686 | 2007-03-13 |
| 1073501110 | Elizabeth Garber Bruning | Psychologist | 10850 E Traverse Hwy, Suite 4000, Traverse City, MI 49684-1364 | 2005-10-12 |
| 1982945093 | Brit Cheryne Lundquist | Psychologist | 105 Hall Street, Traverse City, MI 49686 | 2013-03-14 |
| 1871851683 | Anna Kellogg D'angelo | Psychologist | 512 S Union St, Traverse City, MI 49684-3247 | 2012-04-30 |
| 1790007250 | Marylin Fitzgerald | Psychologist | 512 S Union St, Traverse City, MI 49684-3247 | 2010-02-24 |
| 1427181239 | Dr Kukuk & Dr Haubold PC | Psychologist | 1139 E Front St, Traverse City, MI 49686 | 2007-03-13 |
| 1851440523 | Sarah Paulina Hegg | Psychologist | 1000 Hastings St, Traverse City, MI 49686-3445 | 2007-01-10 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
Please comment or provide details below to improve the information on DR. LINDA KUKUK HAUBOLD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.