Provider Demographics
NPI:1992428122
Name:PEREZ-KOHL, ALEXANDRA (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:PEREZ-KOHL
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2814 COOLIDGE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-4513
Mailing Address - Country:US
Mailing Address - Phone:608-218-4251
Mailing Address - Fax:
Practice Address - Street 1:2814 COOLIDGE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4513
Practice Address - Country:US
Practice Address - Phone:608-218-4251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2315124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist