Provider Demographics
NPI:1699059824
Name:KOKE, NANCY E (LCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:KOKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:E
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1111 ELMWOOD AVE
Mailing Address - Street 2:BLDG 16 2ND FLOOR
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620
Mailing Address - Country:US
Mailing Address - Phone:585-241-1303
Mailing Address - Fax:585-241-1273
Practice Address - Street 1:1111 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-241-1303
Practice Address - Fax:585-241-1273
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071151-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical