Provider Demographics
NPI:1013519164
Name:KOCHELL, MARIAH (PLPC)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:KOCHELL
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 E REPUBLIC RD STE D
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6588
Mailing Address - Country:US
Mailing Address - Phone:417-351-4282
Mailing Address - Fax:844-683-2342
Practice Address - Street 1:1717 E REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-6525
Practice Address - Country:US
Practice Address - Phone:417-351-4282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator