Provider Demographics
NPI:1639499551
Name:COCO, ALFRED J (MS, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:J
Last Name:COCO
Suffix:
Gender:M
Credentials:MS, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BAYLIS CT
Mailing Address - Street 2:FL 1
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3601
Mailing Address - Country:US
Mailing Address - Phone:914-407-4026
Mailing Address - Fax:914-372-7055
Practice Address - Street 1:239 N BROADWAY
Practice Address - Street 2:SUITE 5
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2674
Practice Address - Country:US
Practice Address - Phone:914-407-4026
Practice Address - Fax:914-372-7055
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004394-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health