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1558367565

NPI Code Detail

MEDICARE: MR. STEVEN ALBERT KOSSOR MA

MEDICARE: MR. STEVEN ALBERT KOSSOR MA

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	103T00000X	Psychologist	PS-003680-L	PA
2	103TC2200X	Clinical Child & Adolescent Psychologist	PS-003680-L	PA
3	103TB0200X	Cognitive & Behavioral Psychologist	PS-003680-L	PA
4	103TC0700X	Clinical Psychologist	PS-003680-L	PA
5	103TC1900X	Counseling Psychologist	PS-003680-L	PA
6	103TM1800X	Intellectual & Developmental Disabilities Psychologist	PS-003680-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558367565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN ALBERT KOSSOR MA

Provider Business Mailing Address
First Line	:	848 W KINGS HWY
Second Line	:
City	:	COATESVILLE
State	:	PA
Zip	:	19320-1714
Country	:	US
Telephone Number	:	610-383-9494
Fax Number	:	610-383-9494

Provider Business Practice Location Address
First Line	:	848 W KINGS HWY
Second Line	:
City	:	COATESVILLE
State	:	PA
Zip	:	19320-1714
Country	:	US
Telephone Number	:	610-383-9494
Fax Number	:	610-383-9494

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	01/17/2017

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Directions to “ MR. STEVEN ALBERT KOSSOR MA” Practice Location

Language	Start Address	Practice Location

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