Active NPI
Michelle Maria Koeneke, LCSW
- Clinical Social Worker
- Durham, NC
National Provider Identifier
1144565631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C007947
- Practice address
- Dumc 3868
Durham, NC 27710-0001 - Phone
- (919) 684-3938
- Fax
- (919) 681-9909
- NPI assigned
- Dec 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C007947 | NC | Primary |
Addresses
Primary practice location
Dumc 3868
Durham, NC 27710-0001
Mailing address
Dumc 3868
Durham, NC 27710-0001
Phone (919) 684-3938
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6009250 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C007947 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370563200000",
"number": "1144565631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DUMC 3868",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001",
"telephone_number": "919-684-3938",
"fax_number": "919-681-9909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DUMC 3868",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001",
"telephone_number": "919-684-3938",
"fax_number": "919-681-9909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENEKE",
"first_name": "MICHELLE",
"middle_name": "MARIA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-10",
"last_updated": "2013-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C007947",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6009250",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.