Healthcare Provider Details

I. General information

NPI: 1083870380
Provider Name (Legal Business Name): CLAUDIA KIMBERLY KOSLOW LMHC, MCAP, CTT, CAI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 05/23/2022
Certification Date: 05/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 LAKE AVE STE 4
LAKE WORTH BEACH FL
33460-3847
US

IV. Provider business mailing address

521 LAKE AVE STE 4
LAKE WORTH BEACH FL
33460-3847
US

V. Phone/Fax

Practice location:
  • Phone: 954-540-8441
  • Fax:
Mailing address:
  • Phone: 954-540-8441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAP 2886
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH9363
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: