Provider Demographics
NPI:1053167205
Name:COCCA, KATELYN (LPC)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:
Last Name:COCCA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:969 GRAVEL PIKE
Mailing Address - Street 2:
Mailing Address - City:PALM
Mailing Address - State:PA
Mailing Address - Zip Code:18070-1205
Mailing Address - Country:US
Mailing Address - Phone:610-972-0430
Mailing Address - Fax:
Practice Address - Street 1:969 GRAVEL PIKE
Practice Address - Street 2:
Practice Address - City:PALM
Practice Address - State:PA
Practice Address - Zip Code:18070-1205
Practice Address - Country:US
Practice Address - Phone:610-972-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional