Provider Demographics
NPI:1205278744
Name:KOCOT, KRISTEN ANN (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:ANN
Last Name:KOCOT
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-3236
Mailing Address - Country:US
Mailing Address - Phone:413-348-6967
Mailing Address - Fax:
Practice Address - Street 1:58 PLANTATION DR
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-3236
Practice Address - Country:US
Practice Address - Phone:413-348-6967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health