Provider Demographics
NPI:1356886691
Name:KOCZ, SARAH CATHERINE (MA, LCMHC, LADC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CATHERINE
Last Name:KOCZ
Suffix:
Gender:F
Credentials:MA, LCMHC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 SPRING ST APT 3
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3216
Mailing Address - Country:US
Mailing Address - Phone:240-413-0211
Mailing Address - Fax:
Practice Address - Street 1:ANNA MARSH LANE
Practice Address - Street 2:BRATTLEBORO RETREAT MIND BODY PAIN MANAGEMENT CLINIC
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05302
Practice Address - Country:US
Practice Address - Phone:802-258-6844
Practice Address - Fax:802-258-3743
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000699101YA0400X
VT068.0128938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)