Provider Demographics
NPI:1417427550
Name:KUHSE-PORTZLINE, COLLEEN RENEE (LMFT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:RENEE
Last Name:KUHSE-PORTZLINE
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 LEGION ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1932
Mailing Address - Country:US
Mailing Address - Phone:319-431-0152
Mailing Address - Fax:563-726-7378
Practice Address - Street 1:102 LEGION STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057
Practice Address - Country:US
Practice Address - Phone:319-431-0152
Practice Address - Fax:563-726-7378
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-02
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA089649106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist