MEDICARE: MRS. EMILY S KOHLER LMSW

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	1041C0700X	Clinical Social Worker	6801092212	MI

General Provider Information

NPI Number	:	1770837841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY S KOHLER LMSW

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2012
Last Update Date	:	01/09/2026

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