Provider Demographics
NPI:1356921951
Name:KOSSOY, COLBY JENNA (LMHC)
Entity type:Individual
Prefix:MS
First Name:COLBY
Middle Name:JENNA
Last Name:KOSSOY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 E 68TH ST APT 7E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6013
Mailing Address - Country:US
Mailing Address - Phone:516-319-6971
Mailing Address - Fax:
Practice Address - Street 1:226 E 52ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-6201
Practice Address - Country:US
Practice Address - Phone:516-319-6971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103526-01101YM0800X
NY011473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health