Provider Demographics
NPI:1609040948
Name:KOCHIS, RICHARD ALLEN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALLEN
Last Name:KOCHIS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 N 3RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-3509
Mailing Address - Country:US
Mailing Address - Phone:906-226-7410
Mailing Address - Fax:906-226-9800
Practice Address - Street 1:1029 N 3RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-3509
Practice Address - Country:US
Practice Address - Phone:906-226-7410
Practice Address - Fax:906-226-9800
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010881331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical