Debra L Kohler, LPC
Individual provider Active NPI Professional Counselor · Custer City, PA
NPI 1760076848 · NPPES record last updated Mar 1, 2021
Key facts
- NPI
- 1760076848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- PC004904 (PA)
- Practice address
- 945 South Ave
Custer City, PA 16725-0000 - Phone
- (814) 817-1400
- NPI assigned
- Mar 1, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC004904 | PA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC004904 | PA | Yes |
Addresses
Primary practice location
945 South Ave
Custer City, PA 16725-0000
Mailing address
335 Bolivar Dr
Bradford, PA 16701-3133
Phone (814) 817-1400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PC004904 | Other | PA | BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Bradford | Direct |
Other providers in Custer City, PA
- Beacon Light Behavioral Health
- Children'S Center for Treatment and Education
- Children'S Center for Treatment and Education
- Stephanie E Morra
All providers in Custer City, PA · Professional Counselor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.