Provider Demographics
NPI:1972668259
Name:KOHUT, WILLIAM T SR (MSW/CCSW #312)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:T
Last Name:KOHUT
Suffix:SR
Gender:M
Credentials:MSW/CCSW #312
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:TAYLOR
Other - Last Name:KOHUT
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:166A HENRY LAW AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820
Mailing Address - Country:US
Mailing Address - Phone:603-749-1050
Mailing Address - Fax:603-749-1050
Practice Address - Street 1:166A HENRY LAW AVENUE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820
Practice Address - Country:US
Practice Address - Phone:603-749-1050
Practice Address - Fax:603-749-1050
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80001298Medicaid
NHIE1298Medicare ID - Type UnspecifiedCOUNSELING