Provider Demographics
NPI:1497986426
Name:KOCHINSKI, NIKOLA JILL (LMSW, ACSW)
Entity Type:Individual
Prefix:
First Name:NIKOLA
Middle Name:JILL
Last Name:KOCHINSKI
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 S PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-1897
Mailing Address - Country:US
Mailing Address - Phone:517-367-0670
Mailing Address - Fax:517-367-0681
Practice Address - Street 1:1808 S PENNSYLVANIA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-1897
Practice Address - Country:US
Practice Address - Phone:517-367-0670
Practice Address - Fax:517-367-0681
Is Sole Proprietor?:No
Enumeration Date:2009-08-08
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010581311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical