Koinonia Counseling Center

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

LPC0812 Issued in TN

Legal business name

KOINONIA COUNSELING CENTER

Practice address

3343 Dewine Rd
Knoxville, TN 37921-4211

Phone

(865) 584-6374

Fax

(865) 584-6613

NPI assigned

Aug 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles Sanderfur, LPC, M.EDNPI 1679765150

Title

Owner/Therapist

Phone

(865) 584-6374

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Sanderfur, LPC, M.ED

  • Mental Health Counselor
  • Knoxville, TN
  • NPI 1679765150
  NPD (past) Authorized official
• Reginald Oswald Butler, ED.D, LPC

  • Professional Counselor
  • Knoxville, TN
  • NPI 1093868689
  NPD (past)

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1225220700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 DEWINE RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379214211",
            "telephone_number": "865-584-6374",
            "fax_number": "865-584-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 DEWINE RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379214211",
            "telephone_number": "865-584-6374",
            "fax_number": "865-584-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOINONIA COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "SANDERFUR",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "865-584-6374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC, M.ED"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TN",
            "license": "LPC0812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsten Anne Koenne, CDA,RDA
• Jonathan James Koerten, M.D.
• Eileen Kogen, LPC
• Mackenzie Stephen Kohnle, RN
• Kasey Elizabeth Kohring, WHNP
• Robert William Kolar, MD
• Anicka Kathryn Kolarik, MD
• Kallie Kolarik
• Michael T Kolarik, O.D.
• Joyce Jeanine Kolesar

• Exclusive Provider Organization in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Exclusive Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.