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Individual

LUCA JAYCE KOHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CADC-R, QMHA-R

Contact information

Practice address
1010 11TH AVE SW, ALBANY, OR 97321-2019
(541) 619-9927
Mailing address
1010 11TH AVE SW, ALBANY, OR 97321-2019
(541) 619-9927

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1405403
OR

Other

Enumeration date
03/05/2018
Last updated
10/28/2025
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