Carly Koenig, LAC, MA, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00904600 Issued in NJ

Practice address

714 E Main St
Moorestown, NJ 08057-3068

Phone

(856) 834-3709

Fax

(856) 249-9651

NPI assigned

Apr 22, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Mind Body Soul Wellness Center LLC

  • Professional Counselor
  • Collingswood, NJ
  • NPI 1487152542
  NPD (past)

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1366239378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E MAIN ST",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573068",
            "telephone_number": "856-834-3709",
            "fax_number": "856-249-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E MAIN ST",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573068",
            "telephone_number": "856-834-3709",
            "fax_number": "856-249-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "CARLY",
        "credential": "LAC, MA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37AC00904600",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00904600",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Namjin Kim, PT, DPT
• Marshall Dean Kinsey, M.D.
• Lori Marie Kitts, M.D.
• Jay Klazmer, D.O.
• Maureen Kling, M.D.
• Marissa Kohn, LCSW
• Caitlyn Kollar, PHYSICIAN ASSISTANT
• Sarah Kolp, PT, DPT, OCS
• Eduard Koman, M.D.
• Kari L Koste

• Professional Counselor in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; 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.