Healthcare Provider Details

I. General information

NPI: 1447274329
Provider Name (Legal Business Name): JENNIFER KOSANKE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 NORTH ST SUITE 203
DANBURY CT
06810-5660
US

IV. Provider business mailing address

57 NORTH ST SUITE 203
DANBURY CT
06810-5660
US

V. Phone/Fax

Practice location:
  • Phone: 203-798-2845
  • Fax: 203-791-9094
Mailing address:
  • Phone: 203-798-2845
  • Fax: 203-791-9094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000915
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000915
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: