Provider Demographics
NPI:1124138342
Name:KOHLENBERG, BARBARA (PHD)
Entity type:Individual
Prefix:PROF
First Name:BARBARA
Middle Name:
Last Name:KOHLENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W 2ND ST
Mailing Address - Street 2:235D
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-5345
Mailing Address - Country:US
Mailing Address - Phone:775-682-8175
Mailing Address - Fax:775-327-2006
Practice Address - Street 1:5190 NEIL RD
Practice Address - Street 2:215
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6599
Practice Address - Country:US
Practice Address - Phone:775-784-4917
Practice Address - Fax:775-784-1428
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0326103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVS63831Medicare UPIN
NVCU167ZMedicare PIN