Provider Demographics
NPI:1780697078
Name:COCCIARELLI, KATHERINE (LPC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:COCCIARELLI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 SHELDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:49931-1835
Mailing Address - Country:US
Mailing Address - Phone:906-482-9077
Mailing Address - Fax:906-482-2502
Practice Address - Street 1:609 SHELDEN AVE
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-1835
Practice Address - Country:US
Practice Address - Phone:906-482-9077
Practice Address - Fax:906-482-2502
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005567101YM0800X, 101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor