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General NPI Number Information
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NPI Number | 1952979106
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Entity Type | Organization
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Legal Business Name | KOSIS - KNOWLEDGE OF SELF IS SUPREME
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 222 N E ST
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City | HAMILTON
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State | OH
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Zip | 45013-3048
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Country | US
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Telephone | 614-407-4590
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Fax |
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Provider Business Mailing Address
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Address Line | 222 N E ST
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City | HAMILTON
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State | OH
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Zip | 45013-3048
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Country | US
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Telephone | 614-407-4590
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MIKAEL L WHITE-DAVIS
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Credential | LPCC
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Telephone | 614-407-4590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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