Provider Demographics
NPI:1801565536
Name:KOCHER LONG, CAMARO C (MS, LMFT)
Entity type:Individual
Prefix:
First Name:CAMARO
Middle Name:C
Last Name:KOCHER LONG
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 N RIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-6576
Mailing Address - Country:US
Mailing Address - Phone:316-201-4063
Mailing Address - Fax:
Practice Address - Street 1:1301 W 30TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-2500
Practice Address - Country:US
Practice Address - Phone:620-314-2048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist