Provider Demographics
NPI:1841216264
Name:CSOKASY, JERRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:
Last Name:CSOKASY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6547 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-9720
Mailing Address - Country:US
Mailing Address - Phone:810-334-4055
Mailing Address - Fax:
Practice Address - Street 1:10315 E GRAND RIVER
Practice Address - Street 2:SUITE 304
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116
Practice Address - Country:US
Practice Address - Phone:810-334-4055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008928103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist