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NPI Code Detail

MEDICARE: COURTNEY MARIE KOENIG LCSW, LIMHP

MEDICARE: COURTNEY MARIE KOENIG LCSW, LIMHP
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
11041S0200XSchool Social Worker1568NE

General Provider Information

NPI Number : 1659854941
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY MARIE KOENIG LCSW, LIMHP
Provider Business Mailing Address
First Line : 3706 MAPLE ST
Second Line :
City : OMAHA
State : NE
Zip : 68111-3125
Country : US
Telephone Number : 402-457-5723
Fax Number : 402-457-4932
Provider Business Practice Location Address
First Line : 3706 MAPLE ST
Second Line :
City : OMAHA
State : NE
Zip : 68111-3125
Country : US
Telephone Number : 402-457-5723
Fax Number : 402-457-4932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2018
Last Update Date : 09/12/2018

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Directions to “ COURTNEY MARIE KOENIG LCSW, LIMHP” Practice Location

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