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General NPI Number Information
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NPI Number | 1619379856
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Entity Type | Individual
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Provider Name | KOZMA HOSKINS MCLEAN MS, LPC-QS, LCAS-A,
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 420 FAIRLEY ST STE B
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City | LAURINBURG
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State | NC
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Zip | 28352-3612
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Country | US
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Telephone | 910-610-9151
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Fax | 888-734-8599
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Provider Business Mailing Address
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Address Line | 420 FAIRLEY ST STE B
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City | LAURINBURG
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State | NC
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Zip | 28352-3612
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Country | US
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Telephone | 910-610-9151
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Fax | 888-734-8599
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10781
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License Number State | NC
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