MEDICARE: OZZY LEVI COCARELLI MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1194937607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OZZY LEVI COCARELLI MS

Provider Business Mailing Address
First Line	:	2830 16TH ST NE APT 9
Second Line	:	APT #09
City	:	HICKORY
State	:	NC
Zip	:	28601-8606
Country	:	US
Telephone Number	:	828-256-9443
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 CHURCH ST N
Second Line	:	SUITE 305
City	:	CONCORD
State	:	NC
Zip	:	28025-4300
Country	:	US
Telephone Number	:	704-262-1320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	07/08/2007

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