Provider Demographics
NPI:1902584345
Name:BROWN KOCHMAN, LAURA JANE (MSS, LSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JANE
Last Name:BROWN KOCHMAN
Suffix:
Gender:F
Credentials:MSS, LSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:KOCHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSS, LSW
Mailing Address - Street 1:123 CHESTNUT ST STE 304
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3059
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 CHESTNUT ST STE 304
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3059
Practice Address - Country:US
Practice Address - Phone:215-399-4128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW14046104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker