Healthcare Provider Details

I. General information

NPI: 1013711266
Provider Name (Legal Business Name): KATHRYN THERESA KOZAK LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNTERE EISENBAHNSTR 7
LANDSTUHL RHEINLAND-PFALZ
66849
DE

IV. Provider business mailing address

UNTERE EISENBAHNSTR 7
LANDSTUHL RHEINLAND-PFALZ
66849
DE

V. Phone/Fax

Practice location:
  • Phone: 337-294-6023
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61541052
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: