Provider Demographics
NPI:1114618279
Name:KOCHIS, HOPE ELIZABETH (LLC)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:ELIZABETH
Last Name:KOCHIS
Suffix:
Gender:F
Credentials:LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-1439
Mailing Address - Country:US
Mailing Address - Phone:231-383-2042
Mailing Address - Fax:
Practice Address - Street 1:128 N COURT AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1408
Practice Address - Country:US
Practice Address - Phone:989-448-8344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty