Healthcare Provider Details

I. General information

NPI: 1932459377
Provider Name (Legal Business Name): SALIHA KOZAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BAY STATE RD
BOSTON MA
02215-1506
US

IV. Provider business mailing address

185 BAY STATE RD
BOSTON MA
02215-1506
US

V. Phone/Fax

Practice location:
  • Phone: 617-353-3855
  • Fax: 617-353-5539
Mailing address:
  • Phone: 617-353-3855
  • Fax: 617-353-5539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY11965
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: