Provider Demographics
NPI:1508866062
Name:KOKAREV, JOSEPHINE (MSW)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:KOKAREV
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:
Other - Last Name:KOKAREV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:360 CALOOSA PALMS COURT
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-6939
Mailing Address - Country:US
Mailing Address - Phone:802-233-0077
Mailing Address - Fax:802-229-5226
Practice Address - Street 1:360 CALOOSA PALMS COURT
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6939
Practice Address - Country:US
Practice Address - Phone:802-233-0077
Practice Address - Fax:802-229-5226
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT-0000089-821041C0700X
VT089.00000821041C0700X
FLSW226261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006709Medicaid
VT1006709Medicaid