Casey Kohl, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3719 Issued in OR

Practice address

753 SE Main St # 210
Roseburg, OR 97470-3984

Phone

(541) 671-2040

NPI assigned

Dec 11, 2006

Last updated

Oct 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Casey Kohl LCSW LLC Dba Mid-Valley Mindfulness

  • Clinical Social Worker
  • Roseburg, OR
  • NPI 1730021791
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1851451157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 SE CASS AVE STE 220",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974704953",
            "telephone_number": "541-671-2040",
            "fax_number": "775-623-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 SE MAIN ST # 210",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703984",
            "telephone_number": "541-671-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHL",
        "first_name": "CASEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "3719",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "4957-C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Memory Knight
• Katelynn Knous, RDH
• Gregory J Knutson
• Aimee Kodiaq, FNP
• Alice Koech, A-GNP-C
• Brock Kolander
• Penny L Kollen, RN
• Caitlin Courtney Konicek, DDS
• Jennifer M Kormendi, RDN
• Vishal Kottapalli, DO

• Clinical Social Worker in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.