Joann Koester, LCPC

Individual provider Active NPI Mental Health Counselor · Meridian, ID

NPI 1114196623 · NPPES record last updated Aug 12, 2022

Key facts

NPI
1114196623
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
LCPC206 (ID)
Practice address
2498 N. Stokesberry PL.
Suite 180
Meridian, ID 83646
Phone
(208) 403-7488
Fax
(208) 529-1960
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCPC206IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Change Center, LLC Mental Health Current
since Aug 14, 2022
Accepting new patients

Locations

2498 N Stokesberry Pl
Ste 180
Meridian, ID 83646
Phone (208) 403-7488

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCPC206 ID Yes

Addresses

Primary practice location

2498 N. Stokesberry PL.
Suite 180
Meridian, ID 83646

Mailing address

P.O. Box 409
Meridian, ID 83680-0409
Phone (208) 403-7488

Other identifiers

IdentifierTypeStateIssuer
806472900MedicaidID

Other providers in Meridian, ID

All providers in Meridian, ID · Mental Health Counselor in Idaho

Sources for this page

Verify at the official NPI Registry.