Provider Demographics
NPI:1770837841
Name:KOHLER, EMILY S (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:S
Last Name:KOHLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:STANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:11145 E FORT RD
Mailing Address - Street 2:
Mailing Address - City:SUTTONS BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49682-9516
Mailing Address - Country:US
Mailing Address - Phone:231-715-6071
Mailing Address - Fax:
Practice Address - Street 1:1240 S BAY VIEW TRL
Practice Address - Street 2:
Practice Address - City:SUTTONS BAY
Practice Address - State:MI
Practice Address - Zip Code:49682-9619
Practice Address - Country:US
Practice Address - Phone:231-715-6071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010922121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical