Provider Demographics
NPI:1639699895
Name:KOKAREVA, SVETLANA (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:KOKAREVA
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 DELAWARE AVE # 206
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6169
Mailing Address - Country:US
Mailing Address - Phone:720-526-8102
Mailing Address - Fax:
Practice Address - Street 1:126 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5347
Practice Address - Country:US
Practice Address - Phone:813-689-8828
Practice Address - Fax:813-689-8802
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016879101YM0800X
FLMH18316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health