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General NPI Number Information
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NPI Number | 1841499464
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Entity Type | Individual
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Provider Name | JILL KOEHN LPC
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Gender | Female
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 251 WALNUT ST
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3111
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Country | US
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Telephone | 307-220-3408
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Fax |
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Provider Business Mailing Address
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Address Line | 251 WALNUT ST
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3111
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Country | US
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Telephone | 307-220-3408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 329
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD671
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 841
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CCMH0183381
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2427
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License Number State | CO
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