Provider Demographics
NPI:1245379809
Name:KOZLOWSKI, WILLA J (LCPC)
Entity Type:Individual
Prefix:
First Name:WILLA
Middle Name:J
Last Name:KOZLOWSKI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 W 94TH TER
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2504
Mailing Address - Country:US
Mailing Address - Phone:913-261-9086
Mailing Address - Fax:913-273-0944
Practice Address - Street 1:5350 W. 94TH TERRRACE
Practice Address - Street 2:SUITE 204
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207
Practice Address - Country:US
Practice Address - Phone:913-261-9086
Practice Address - Fax:913-273-0944
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2246101YP2500X
MO2187101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional