Provider Demographics
NPI:1295533651
Name:KOKO, ALLOU S (LGPC)
Entity type:Individual
Prefix:
First Name:ALLOU
Middle Name:S
Last Name:KOKO
Suffix:
Gender:
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11023 GRASSY KNOLL TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6355
Mailing Address - Country:US
Mailing Address - Phone:574-903-6590
Mailing Address - Fax:
Practice Address - Street 1:3701 OLD COURT RD STE 18A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3901
Practice Address - Country:US
Practice Address - Phone:410-680-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16061101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty