Provider Demographics
NPI:1093038499
Name:MOCHIZUKI, KOHEI (LMHC)
Entity Type:Individual
Prefix:MR
First Name:KOHEI
Middle Name:
Last Name:MOCHIZUKI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 PELICAN BAY DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32119-9700
Mailing Address - Country:US
Mailing Address - Phone:386-868-1992
Mailing Address - Fax:386-868-1978
Practice Address - Street 1:1060 PELICAN BAY DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32119-9700
Practice Address - Country:US
Practice Address - Phone:386-868-1992
Practice Address - Fax:386-868-1978
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health