Provider Demographics
NPI:1205036381
Name:COSSETTE, KATHERINE DEJOY (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DEJOY
Last Name:COSSETTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 FRAZIER PARK DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1520
Mailing Address - Country:US
Mailing Address - Phone:404-630-4524
Mailing Address - Fax:
Practice Address - Street 1:2801 BUFORD HWY NE STE 190
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-2124
Practice Address - Country:US
Practice Address - Phone:404-630-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor