Provider Demographics
NPI:1427287093
Name:COZZO, DARLEENA RAE (MALPCMSSP)
Entity type:Individual
Prefix:MRS
First Name:DARLEENA
Middle Name:RAE
Last Name:COZZO
Suffix:
Gender:
Credentials:MALPCMSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 CLINTON HWY STE 204
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-1121
Mailing Address - Country:US
Mailing Address - Phone:865-455-8048
Mailing Address - Fax:
Practice Address - Street 1:6515 CLINTON HWY STE 204
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1121
Practice Address - Country:US
Practice Address - Phone:865-455-8048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-04
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2358101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health