# CASEY KOHL LCSW LLC DBA MID-VALLEY MINDFULNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730021791
- **Authorized official:** CASEY KOHL LCSW (OWNER)
- **Authorized official phone:** (458) 280-9031

## Contact information

- **Practice address:** 1701 W HARVARD AVE \# 204, ROSEBURG, OR 97471-2716
- **Practice address phone:** (458) 280-9031
- **Mailing address:** 1701 W HARVARD AVE \# 204, ROSEBURG, OR 97471-2716
- **Mailing address phone:** (459) 280-9031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 04/08/2026
- **Last updated:** 04/08/2026