Provider Demographics
NPI:1801662549
Name:KOIS, MATTHEW DONALD (LMHC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DONALD
Last Name:KOIS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SHORELINE PKWY APT 306
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2288
Mailing Address - Country:US
Mailing Address - Phone:716-796-9187
Mailing Address - Fax:
Practice Address - Street 1:320 SHORELINE PKWY APT 306
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-2288
Practice Address - Country:US
Practice Address - Phone:716-796-9187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health