Shoshana Diane Sagner Koch, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19703 Issued in MN

Practice address

7582 Currell Blvd Ste 208
Woodbury, MN 55125-2471

Phone

(612) 234-1150

NPI assigned

Aug 4, 2012

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Minnesota Online Counseling LLC

  • Marriage & Family Therapist
  • White Bear Lake, MN
  • NPI 1609255694
  Medicare reassignment NPD

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

{
    "created_epoch": "1344038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1255688602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7582 CURRELL BLVD STE 208",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252471",
            "telephone_number": "612-234-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7582 CURRELL BLVD STE 208",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252471",
            "telephone_number": "612-234-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "SHOSHANA",
        "middle_name": "DIANE SAGNER",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-04",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brigitte M Knoll
• Susan Martha Knutson
• Allison Maria Kobilka
• Hannah Jiankan Koch, PT, DPT
• James William Koch, D.O.
• Paul E. Kocian, DDS
• Marykatherine F Kocourek
• Paige Kocourek
• Christopher E Koehn, DDS
• Jody Koerper

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.