Provider Demographics
NPI:1336420322
Name:KOCET, SUZANNE (MA, LBS, LPC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:KOCET
Suffix:
Gender:F
Credentials:MA, LBS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 S BURROWES ST STE 706
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-3864
Mailing Address - Country:US
Mailing Address - Phone:814-753-1071
Mailing Address - Fax:
Practice Address - Street 1:119 S BURROWES ST STE 706
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-3864
Practice Address - Country:US
Practice Address - Phone:814-753-1071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001906101YM0800X, 103K00000X
PAPC014777101YP2500X, 101YP2500X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst