Evan Koehn, PHD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301018854 Issued in MI

Practice address

926 W Center Rd
Essexville, MI 48732-2006

Phone

(989) 928-5095

NPI assigned

Oct 21, 2015

Last updated

Aug 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MI

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

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saginaw County Community Mental Health AuthorityGroup PAC ID 7719037332, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saginaw County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Saginaw, MI
  • NPI 1689778953
  Medicare reassignment Care Compare group NPD
• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD
• Supportive Care I of Michigan PC

  • Clinical Psychologist
  • Iron River, MI
  • NPI 1548995608
  Medicare reassignment NPD

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693008000000",
    "number": "1275905911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 W CENTER RD",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487322006",
            "telephone_number": "989-928-5095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 S 44th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681313727",
            "country_code": "US",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2023-08-26",
        "certification_date": "2023-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan J Kaczynski, RPH
• Jad Aiman Kawas
• Taylor Keyes
• Abigail King
• Arturas Klugas, MD
• Melissa Kohner, DO
• Ekaterini Kostakos
• Bethany Kozielski, RPH
• Kroger Co of Michigan (Kroger Pharmacy)
• Alivia Jo Kukla

• Clinical Psychologist in Essexville, MI
• Providers in Essexville, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.