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General NPI Number Information
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NPI Number | 1891945911
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Entity Type | Individual
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Provider Name | NANCY CATHERINE KOEPKE LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 01/06/2015
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Provider Practice Location Address
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Address Line | 211 19TH STREET
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City | ROCK ISLAND
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State | IL
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Zip | 61201-7164
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Country | US
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Telephone | 309-786-3591
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Fax | 309-786-3591
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Provider Business Mailing Address
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Address Line | 211 19TH ST
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City | ROCK ISLAND
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State | IL
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Zip | 61201-8028
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Country | US
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Telephone | 309-786-3591
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Fax | 309-786-5135
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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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 |
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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 |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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Taxonomy #5
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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