Provider Demographics
NPI:1245633601
Name:KOEHLER, ESTHER OPAL (MS, LPC)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:OPAL
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:OPAL
Other - Middle Name:
Other - Last Name:RESPETO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:4104 LIBERTY LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-3636
Mailing Address - Country:US
Mailing Address - Phone:573-330-3974
Mailing Address - Fax:
Practice Address - Street 1:400 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1716
Practice Address - Country:US
Practice Address - Phone:573-330-9374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014034538101YP2500X, 101YA0400X
MO20140034538101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)