MEDICARE: MS. LEEANN KOT M.A., L.M.H.C.

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	MH 8279	FL

General Provider Information

NPI Number	:	1902946171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEEANN KOT M.A., L.M.H.C.

Provider Business Mailing Address
First Line	:	3824 HERITAGE OAKS CT
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-9200
Country	:	US
Telephone Number	:	407-592-5222
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 N WYMORE RD
Second Line	:	SUITE 200
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2808
Country	:	US
Telephone Number	:	407-975-2565
Fax Number	:	407-975-2586

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/09/2007

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