Provider Demographics
NPI:1952283541
Name:KOHLER, MARY LILLIAN (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LILLIAN
Last Name:KOHLER
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:CARLISI
Other - Last Name:KOHLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LMSW
Mailing Address - Street 1:3400 BALBOA LN APT 11
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3702
Mailing Address - Country:US
Mailing Address - Phone:660-234-2755
Mailing Address - Fax:
Practice Address - Street 1:19 E WALNUT ST STE D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4505
Practice Address - Country:US
Practice Address - Phone:573-442-7232
Practice Address - Fax:877-307-8772
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250262581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical