Provider Demographics
NPI:1306391321
Name:COKL, HEATHER AUTUMN (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:AUTUMN
Last Name:COKL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 OLDWICK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-4025
Mailing Address - Country:US
Mailing Address - Phone:513-442-8183
Mailing Address - Fax:513-354-1313
Practice Address - Street 1:1074 WASSERMAN WAY
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-1911
Practice Address - Country:US
Practice Address - Phone:513-354-1317
Practice Address - Fax:513-354-1313
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1000401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional