Provider Demographics
NPI:1811555055
Name:KOEHLER, EMILY KATHRYN (LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KATHRYN
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 LONGWELL PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3900
Mailing Address - Country:US
Mailing Address - Phone:317-250-7984
Mailing Address - Fax:
Practice Address - Street 1:515 N GREEN ST STE 402
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2115
Practice Address - Country:US
Practice Address - Phone:317-852-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003535A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health