Provider Demographics
NPI:1235342551
Name:KOSS, ARI MATTHEW (LPC)
Entity Type:Individual
Prefix:MR
First Name:ARI
Middle Name:MATTHEW
Last Name:KOSS
Suffix:
Gender:M
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:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-0032
Mailing Address - Country:US
Mailing Address - Phone:231-832-2247
Mailing Address - Fax:231-832-3281
Practice Address - Street 1:624 SILVER BIRCH ST
Practice Address - Street 2:
Practice Address - City:HOWARD CITY
Practice Address - State:MI
Practice Address - Zip Code:49329-8665
Practice Address - Country:US
Practice Address - Phone:231-832-2247
Practice Address - Fax:231-832-3281
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008584251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health