Provider Demographics
NPI:1871713057
Name:COGAR, MARIE KAY (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:KAY
Last Name:COGAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WELLSPRING ROAD
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983
Mailing Address - Country:US
Mailing Address - Phone:518-891-0569
Mailing Address - Fax:
Practice Address - Street 1:2841 NYS ROUTE 73
Practice Address - Street 2:SUITE 3
Practice Address - City:KEENE
Practice Address - State:NY
Practice Address - Zip Code:12942-9998
Practice Address - Country:US
Practice Address - Phone:518-576-4557
Practice Address - Fax:518-576-9713
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY000371-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health