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NPI Code Detail

MEDICARE: MRS. CORINA H KOJACK LPC

MEDICARE:  MRS. CORINA H KOJACK  LPC
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
1101YP2500XProfessional Counselor0701004404VA

General Provider Information

NPI Number : 1538313069
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CORINA H KOJACK LPC
Provider Business Mailing Address
First Line : PO BOX 62018
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23466-2018
Country : US
Telephone Number : 757-631-0099
Fax Number : 757-631-4971
Provider Business Practice Location Address
First Line : 4937 CLEVELAND ST
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-5301
Country : US
Telephone Number : 757-631-0099
Fax Number : 757-631-4971
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2008
Last Update Date : 07/10/2012

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Directions to “ MRS. CORINA H KOJACK LPC” Practice Location

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