Healthcare Provider Details

I. General information

NPI: 1477977213
Provider Name (Legal Business Name): JOHN KOHAGEN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4521 CHADWICK RD STE 2
CEDAR FALLS IA
50613-8045
US

IV. Provider business mailing address

4521 CHADWICK RD STE 2
CEDAR FALLS IA
50613-8045
US

V. Phone/Fax

Practice location:
  • Phone: 319-239-3533
  • Fax: 888-972-4788
Mailing address:
  • Phone: 319-239-3533
  • Fax: 888-972-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number93246
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: