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General NPI Number Information
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NPI Number | 1124319231
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Entity Type | Individual
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Provider Name | STEVEN KOCH M.A., LPCC
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Gender | Male
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 1505 15TH ST SUITE C
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City | LOS ALAMOS
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State | NM
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Zip | 87544-3000
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Country | US
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Telephone | 505-662-3264
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Fax | 505-662-9707
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Provider Business Mailing Address
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Address Line | 1505 15TH ST SUITE C
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City | LOS ALAMOS
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State | NM
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Zip | 87544-3000
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Country | US
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Telephone | 505-662-3264
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Fax | 505-662-9707
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0165781
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License Number State | NM
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