Michelle J. Koerner, MED, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002488 Issued in MO

Practice address

1310 HRC Plaza Dr
Lake St Louis, MO 63367-1869

Phone

(636) 339-4475

Fax

(636) 201-3379

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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 MO

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

A W Stevenson LLCGroup PAC ID 8628437092, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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.

• A W Stevenson LLC

  dba Ellie Mental Health

  • Professional Counselor
  • Saint Charles, MO
  • NPI 1396469060
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1093869745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PITTSFIELD CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172040",
            "telephone_number": "314-330-3891",
            "fax_number": "314-830-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HRC PLAZA DR",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671869",
            "telephone_number": "636-339-4475",
            "fax_number": "636-201-3379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "237 Creekside Office Dr",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "63385",
            "country_code": "US",
            "telephone_number": "636-202-1412",
            "fax_number": "636-201-3379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N 5th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633011808",
            "country_code": "US",
            "telephone_number": "636-238-2615",
            "fax_number": "636-201-3379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "MICHELLE",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "MED, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH21728",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "002488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499774008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marissa Kistner, M.ED., LPC
• Kathleen M. Kloeckner, ANP-BC
• Melvin Eugene Kottwitz, RPH
• Tia L Kraemer, MA, LPC
• Robert Elroy Kraetsch, MD
• Andrew Edward Kreutzer
• Lana Marie Kruse, RD, LD

• Professional Counselor in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.