Healthcare Provider Details

I. General information

NPI: 1447546056
Provider Name (Legal Business Name): DR. LINDA KOENIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 83
MINFORD OH
45653-0083
US

IV. Provider business mailing address

565 EAST ST
MINFORD OH
45653-8507
US

V. Phone/Fax

Practice location:
  • Phone: 614-602-1077
  • Fax:
Mailing address:
  • Phone: 740-357-1051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0008408
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: