Healthcare Provider Details

I. General information

NPI: 1669150413
Provider Name (Legal Business Name): STEPHEN KOCHENASH LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LAWRENCE ST FL 2
BROOKLYN NY
11201-3812
US

IV. Provider business mailing address

525 W 28TH ST APT 733
NEW YORK NY
10001-6632
US

V. Phone/Fax

Practice location:
  • Phone: 929-523-4512
  • Fax:
Mailing address:
  • Phone: 917-992-1036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP119520
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: