Provider Demographics
NPI:1114340239
Name:KOKOLIS, MARIA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:KOKOLIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 SIR GEORGE PERCY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-8256
Mailing Address - Country:US
Mailing Address - Phone:757-592-2098
Mailing Address - Fax:
Practice Address - Street 1:528 SIR GEORGE PERCY
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-8256
Practice Address - Country:US
Practice Address - Phone:757-592-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional