Lydia Jane Koch, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

187965 Issued in AK

Practice address

35037 Royal PL
Soldotna, AK 99669-9755

Phone

(907) 299-8871

NPI assigned

Apr 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1235635558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "ANCHOR POINT",
            "state": "AK",
            "postal_code": "995560369",
            "telephone_number": "907-299-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35037 ROYAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996699755",
            "telephone_number": "907-299-8871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1091 E End Rd",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037206",
            "country_code": "US",
            "telephone_number": "907-416-2415",
            "fax_number": "907-416-2598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "LYDIA",
        "middle_name": "JANE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "187965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.