Provider Demographics
NPI:1013265875
Name:NKOSI, BAKARI M (BA)
Entity Type:Individual
Prefix:
First Name:BAKARI
Middle Name:M
Last Name:NKOSI
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 ALBERT DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2204
Mailing Address - Country:US
Mailing Address - Phone:206-954-9724
Mailing Address - Fax:
Practice Address - Street 1:3936 S KENYON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4048
Practice Address - Country:US
Practice Address - Phone:206-302-2771
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
WACO60598008390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program