Provider Demographics
NPI:1912957382
Name:COKER, KATHRYN LYNN (LMHC)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LYNN
Last Name:COKER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 GRASSGLEN PL
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7335
Mailing Address - Country:US
Mailing Address - Phone:813-458-5751
Mailing Address - Fax:
Practice Address - Street 1:3229 GRASSGLEN PL
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7335
Practice Address - Country:US
Practice Address - Phone:813-458-5751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00960600101YP2500X
FLMH5997101YM0800X, 103TC1900X
FLMH 5997101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009476100Medicaid