Provider Demographics
NPI:1821816810
Name:KOS HOUSE THERAPY, PLLC
Entity type:Organization
Organization Name:KOS HOUSE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MENTAL HEALTH PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:KENDYL
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HOVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:479-895-1313
Mailing Address - Street 1:2700 SE OTIS CORLEY DR STE 14
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4184
Mailing Address - Country:US
Mailing Address - Phone:479-895-1313
Mailing Address - Fax:479-397-4813
Practice Address - Street 1:2700 SE OTIS CORLEY DR STE 14
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4184
Practice Address - Country:US
Practice Address - Phone:479-895-1313
Practice Address - Fax:479-397-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty