Provider Demographics
NPI:1851694210
Name:KOK, KELSEY DAWN (BSW)
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:DAWN
Last Name:KOK
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5055
Mailing Address - Country:US
Mailing Address - Phone:360-676-2164
Mailing Address - Fax:360-676-2144
Practice Address - Street 1:160 CASCADE PL
Practice Address - Street 2:# 201
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3126
Practice Address - Country:US
Practice Address - Phone:360-856-3054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health