MEDICARE: LINDSEY KOCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker		KY
2	104100000X	Social Worker	I.2405354	OH

General Provider Information

NPI Number	:	1174119424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY KOCH

Provider Business Mailing Address
First Line	:	6415 FAIR OAKS AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4509
Country	:	US
Telephone Number	:	598-512-5392
Fax Number	:

Provider Business Practice Location Address
First Line	:	6415 FAIR OAKS AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4509
Country	:	US
Telephone Number	:	598-512-5392
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2020
Last Update Date	:	01/19/2026

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Directions to “ LINDSEY KOCH ” Practice Location

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