MEDICARE: EMILY S. KOHLER, LMSW PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1043968423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMILY S. KOHLER, LMSW PLLC

Provider Business Mailing Address
First Line	:	11145 E FORT RD
Second Line	:
City	:	SUTTONS BAY
State	:	MI
Zip	:	49682-9516
Country	:	US
Telephone Number	:	231-715-6071
Fax Number	:

Provider Business Practice Location Address
First Line	:	10161 E PICKWICK CT STE A
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-5239
Country	:	US
Telephone Number	:	231-261-1942
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EMILY KOHLER
Credential	:	LMSW
Telephone Number	:	231-715-6071

Provider Enumeration Date	:	03/14/2022
Last Update Date	:	01/09/2026

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