Provider Demographics
NPI:1932394400
Name:KOHLERITER, DENA (LCSW)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:KOHLERITER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7123 HUNTERS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-5205
Mailing Address - Country:US
Mailing Address - Phone:972-365-9262
Mailing Address - Fax:
Practice Address - Street 1:1721 W PLANO PKWY STE 107
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8633
Practice Address - Country:US
Practice Address - Phone:469-737-0451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX319641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX31964OtherSTATE LICENSE