Provider Demographics
NPI:1700935418
Name:KOEHLER, ALISON B (LCPC)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:B
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17540 W WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1691
Mailing Address - Country:US
Mailing Address - Phone:847-924-4793
Mailing Address - Fax:847-856-0867
Practice Address - Street 1:4343 OLD GRAND AVE
Practice Address - Street 2:SUITE 107 C
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2767
Practice Address - Country:US
Practice Address - Phone:847-924-4793
Practice Address - Fax:847-865-0867
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL04932302101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health