Provider Demographics
NPI:1184495913
Name:ALYSON REYNOLDS KOHL LMFT FAMILY THERAPIST LLC
Entity type:Organization
Organization Name:ALYSON REYNOLDS KOHL LMFT FAMILY THERAPIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER LLC
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:REYNOLDS
Authorized Official - Last Name:KOHL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-638-3368
Mailing Address - Street 1:2323 CHURN CREEK RD UNIT 492102
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-5328
Mailing Address - Country:US
Mailing Address - Phone:530-638-3368
Mailing Address - Fax:530-653-2332
Practice Address - Street 1:2628 VICTOR AVE STE C
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1454
Practice Address - Country:US
Practice Address - Phone:530-638-3368
Practice Address - Fax:530-653-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty