Keith Richard Kokseng, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9814 Issued in FL

Practice address

2804 1St Ave S
Saint Petersburg, FL 33712-1002

Phone

(813) 523-7563

NPI assigned

Feb 23, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1356476782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 1ST AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337121002",
            "telephone_number": "727-201-2485",
            "fax_number": "813-272-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 1ST AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337121002",
            "telephone_number": "813-523-7563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5707 N 22nd Street",
            "address_2": "Mental Health Care Inc",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33610",
            "country_code": "US",
            "telephone_number": "813-272-2878 x218",
            "fax_number": "813-272-3766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOKSENG",
        "first_name": "KEITH",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lynn Kocisky, DNP ARNP-C
• Christopher J Koebbe, MD
• Elizabeth Leigh Koehler
• Megan Kohut
• Deann Michelle Kokemohr, DPT
• Richard Kolanda, DDS, RPH
• Amy Joan Koler, MD
• Rachel A Kollar, LMHC
• Robyn Marie Kolodziej, M.ED. R.B.T.
• Demetrios John Kolovos, PHARMD

• Clinical Psychologist in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.