Provider Demographics
NPI:1205411279
Name:KOSOFSKY, NAAMI (LCSW)
Entity Type:Individual
Prefix:
First Name:NAAMI
Middle Name:
Last Name:KOSOFSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 NEILSON ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4719
Mailing Address - Country:US
Mailing Address - Phone:248-752-9566
Mailing Address - Fax:
Practice Address - Street 1:1139 NEILSON ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4719
Practice Address - Country:US
Practice Address - Phone:248-752-9566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011055691041C0700X
NY0953431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical