Individual provider Active NPI

Richard Kenneth Koepke, M.S., M.DIV

  • Marriage & Family Therapist
  • Amherst, NY
National Provider Identifier
1023295003
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000040 Issued in NY
Practice address
57 Labelle Ter
Amherst, NY 14228-1330
Phone
(716) 688-5002
NPI assigned
Jan 22, 2008
Last updated
Jan 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 000551 NY
Marriage & Family Therapist 106H00000X 000040 NY Primary

Addresses

Primary practice location

57 Labelle Ter
Amherst, NY 14228-1330

Mailing address

57 Labelle Ter
Amherst, NY 14228-1330
Phone (716) 688-5002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000040NYMDMental Health Counselor
000551NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1023295003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 LABELLE TER",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142281330",
            "telephone_number": "716-688-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 LABELLE TER",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142281330",
            "telephone_number": "716-688-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPKE",
        "first_name": "RICHARD",
        "middle_name": "KENNETH",
        "credential": "M.S., M.DIV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000551",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "000040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.