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NPI Code Detail

MEDICARE: STEPHANIE KOCH LPCC

MEDICARE: STEPHANIE KOCH LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorCCMH0202931NM

General Provider Information

NPI Number : 1437501913
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE KOCH LPCC
Provider Business Mailing Address
First Line : 195 EAST RD STE 104
Second Line :
City : LOS ALAMOS
State : NM
Zip : 87544-4301
Country : US
Telephone Number : 505-412-7756
Fax Number :
Provider Business Practice Location Address
First Line : 195 EAST RD STE 104
Second Line :
City : LOS ALAMOS
State : NM
Zip : 87544-4301
Country : US
Telephone Number : 505-412-7756
Fax Number : 505-662-8859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2016
Last Update Date : 07/22/2022

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Directions to “ STEPHANIE KOCH LPCC” Practice Location

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