Provider Demographics
NPI:1003554296
Name:KOHLER, SPENCER (ACMHC)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:KOHLER
Suffix:
Gender:M
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1536
Mailing Address - Street 2:
Mailing Address - City:PAROWAN
Mailing Address - State:UT
Mailing Address - Zip Code:84761-1536
Mailing Address - Country:US
Mailing Address - Phone:435-393-5122
Mailing Address - Fax:
Practice Address - Street 1:2069 N MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-5602
Practice Address - Country:US
Practice Address - Phone:435-267-4212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6388761-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health