Provider Demographics
NPI:1851180301
Name:KOZLOWSKI, ANTHONY (AMFT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:KOZLOWSKI
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7651 LAUREL CANYON BLVD APT 201
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-7417
Mailing Address - Country:US
Mailing Address - Phone:707-227-7040
Mailing Address - Fax:
Practice Address - Street 1:4443 AMBROSE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-2114
Practice Address - Country:US
Practice Address - Phone:510-605-7380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC16744101YM0800X
CAAMFT147160106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health