Healthcare Provider Details

I. General information

NPI: 1851072219
Provider Name (Legal Business Name): SARAH KOZROSH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 MAIN ST STE 1R
LITTLE FALLS NJ
07424-1150
US

IV. Provider business mailing address

77 LAKESIDE AVE
POMPTON LAKES NJ
07442-1741
US

V. Phone/Fax

Practice location:
  • Phone: 973-200-2616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01260300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: