Staci Jo Couchman, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

005165 Issued in OH

Practice address

3919 Hope LN
Erlanger, KY 41018-1667

Phone

(765) 894-0838

NPI assigned

Sep 29, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1174032403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 TILDEN AVE",
            "city": "NORWOOD",
            "state": "OH",
            "postal_code": "452122517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 HOPE LN",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410181667",
            "telephone_number": "765-894-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCHMAN",
        "first_name": "STACI",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KY",
            "license": "A5827",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "005165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concentra Health Services, Inc.
• Connor and Associates
• Ed Connor, PH.D.
• Mary Gina Connor, MSW, LCSW
• Jessica Faye Cooper, PHARM D
• Creative Therapeutic Connections LLC
• Creative Therapy Solutions PLLC
• Critical Stress & Wellness Center, LLC
• Margaret W Crouch
• Maria Da Silva, CD(DONA)

• All providers in Erlanger, KY
• Occupational Therapy Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.