Provider Demographics
NPI:1669605879
Name:KOSS IONATA, KATHERINE JEAN (LMHC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:JEAN
Last Name:KOSS IONATA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:JEAN
Other - Last Name:KOSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:56 SCARSDALE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2867
Mailing Address - Country:US
Mailing Address - Phone:508-443-4003
Mailing Address - Fax:
Practice Address - Street 1:56 SCARSDALE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2867
Practice Address - Country:US
Practice Address - Phone:508-443-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4323101YM0800X
RI0691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health