Healthcare Provider Details

I. General information

NPI: 1245521236
Provider Name (Legal Business Name): JOHN C KOCH LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 ARMSTRONG RD
BATTLE CREEK MI
49037-7314
US

IV. Provider business mailing address

11612 RIDGEWAY CT
HOLLAND MI
49424-7507
US

V. Phone/Fax

Practice location:
  • Phone: 616-249-5300
  • Fax:
Mailing address:
  • Phone: 616-283-9215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: