Provider Demographics
NPI:1780452136
Name:KOHLMEYER, BETHANY (MSW)
Entity type:Individual
Prefix:MISS
First Name:BETHANY
Middle Name:
Last Name:KOHLMEYER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 4TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:IA
Mailing Address - Zip Code:50644-2538
Mailing Address - Country:US
Mailing Address - Phone:319-238-2238
Mailing Address - Fax:
Practice Address - Street 1:611 4TH AVE SW
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:IA
Practice Address - Zip Code:50644-2538
Practice Address - Country:US
Practice Address - Phone:319-238-2238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool