Provider Demographics
NPI:1477646784
Name:KOSITZ, JOAN M (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:M
Last Name:KOSITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BARRETT CIRCLE CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-4439
Mailing Address - Country:US
Mailing Address - Phone:845-489-1079
Mailing Address - Fax:845-225-0119
Practice Address - Street 1:3 BARRETT CIRCLE CT
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-4439
Practice Address - Country:US
Practice Address - Phone:845-489-1079
Practice Address - Fax:845-225-0119
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0348941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical