Carolyn Bradley Koch, M.A., L.M.H.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

003135 Issued in NY

Practice address

3532 James St
Syracuse, NY 13206-2488

Phone

(315) 463-9413

NPI assigned

Jan 15, 2007

Sex

Female

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1871644153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3532 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132062488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3532 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132062488",
            "telephone_number": "315-463-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "CAROLYN",
        "middle_name": "BRADLEY",
        "credential": "M.A., L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "003135",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "003135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Ko, PT, RN
• Timothy Allen Ko, RPA-C
• Hazar Kobayaa, M.D.
• Katsuhiro Kobayashi, M.D.
• Amanda Kobus, MA, RD, CDN
• Jacqueline Koch
• Danielle Kochen, MD
• Sarthak Kochhar, MD
• Kathy Kocik
• Sonali Koduri

• Mental Health Counselor in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.