Healthcare Provider Details

I. General information

NPI: 1295454791
Provider Name (Legal Business Name): ROCHELLE J KOEHNE LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W SUPERIOR ST STE 1000
DULUTH MN
55802-1818
US

IV. Provider business mailing address

306 W SUPERIOR ST STE 1000
DULUTH MN
55802-1818
US

V. Phone/Fax

Practice location:
  • Phone: 218-481-7770
  • Fax: 218-216-1452
Mailing address:
  • Phone: 218-481-7770
  • Fax: 218-216-1452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32639
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: