Healthcare Provider Details

I. General information

NPI: 1912957382
Provider Name (Legal Business Name): KATHRYN LYNN COKER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 10/26/2024
Certification Date: 10/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 GRASSGLEN PL
WESLEY CHAPEL FL
33544-7335
US

IV. Provider business mailing address

3229 GRASSGLEN PL
WESLEY CHAPEL FL
33544-7335
US

V. Phone/Fax

Practice location:
  • Phone: 813-458-5751
  • Fax:
Mailing address:
  • Phone: 813-458-5751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00960600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH5997
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberMH5997
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 5997
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: