Leatanya Koppa, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3178 Issued in KS

Practice address

6606 W Central Ave
Wichita, KS 67212-3315

Phone

(316) 221-2661

Fax

(316) 636-1190

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Leatanya E Koppa, LLC

  • Professional Counselor
  • Wichita, KS
  • NPI 1316839061
  Medicare reassignment NPD
• The Therapy Center, LLC

  • Group Psychotherapy Psychologist
  • Wichita, KS
  • NPI 1962201483
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1013410083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6606 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123315",
            "telephone_number": "316-221-2661",
            "fax_number": "316-636-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123315",
            "telephone_number": "316-221-2661",
            "fax_number": "316-636-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPA",
        "first_name": "LEATANYA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "03287",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "3178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004590570003",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Kononowicz
• Travis Koochel
• Timothy Howard Koontz, OTR-L
• Julie Kopf
• Amie Kopischke Stambaugh, LPC, LAC
• John P Korbel
• Jacob Kordonowy
• Jennifer Kordonowy, MA CCC-SLP
• Camille M Korschgen, CTRS
• David Kevin Kortje, M.D.

• Professional Counselor in Wichita, KS
• Providers in Wichita, KS by specialty
• Professional Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.