Provider Demographics
NPI:1295970960
Name:TSOKAS, PANAYIOTA (SCHOOL COUNSELOR)
Entity type:Individual
Prefix:
First Name:PANAYIOTA
Middle Name:
Last Name:TSOKAS
Suffix:
Gender:F
Credentials:SCHOOL COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 MCDONALD AVE
Mailing Address - Street 2:400 GRANDVIEW AVE.
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401
Mailing Address - Country:US
Mailing Address - Phone:928-530-2885
Mailing Address - Fax:928-753-1418
Practice Address - Street 1:3033 MCDONALD AVE
Practice Address - Street 2:400 GRANDVIEW AVE.
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-4235
Practice Address - Country:US
Practice Address - Phone:928-530-2885
Practice Address - Fax:928-753-1418
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YA0400X
AZ3911196101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ883787OtherARIZONA HEALTH CARE COST CONTAINMENT SYSTEM