Provider Demographics
NPI:1114028396
Name:BOKOWSKI, JOSEPHINE LUZ (LMHC, NCC, CBA)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:LUZ
Last Name:BOKOWSKI
Suffix:
Gender:F
Credentials:LMHC, NCC, CBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W GENUNG ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-7069
Mailing Address - Country:US
Mailing Address - Phone:904-797-5499
Mailing Address - Fax:904-797-6574
Practice Address - Street 1:50 SARAGOSSA STREET
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084
Practice Address - Country:US
Practice Address - Phone:904-829-1770
Practice Address - Fax:904-825-0604
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health