Maleah Koppa, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C014206 Issued in NC

Practice address

2260 Denise LN
Winston Salem, NC 27127-8785

Phone

(970) 640-4871

NPI assigned

Sep 25, 2021

Sex

Female

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 NC

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 Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thriveworks Clinical - North Carolina PCGroup PAC ID 8527471200, 109 clinicians

Practice addresses (Care Compare)

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.

• Thriveworks Clinical - North Carolina PC

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1003303082
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1396416665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 DENISE LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278785",
            "telephone_number": "970-640-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 DENISE LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278785",
            "telephone_number": "970-640-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPA",
        "first_name": "MALEAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-25",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Louis Koontz
• Morgan Koontz, PA-C
• Thomas J. Koontz, M.D.
• Gwyn E Kooy, M.D.
• Bryan Matthew Koppa, MD
• Ivana Korankyi, PHARMACIST
• Aryn Elizabeth Kormanis, DO
• John Korona
• Bill Gus Kortesis, M.D.
• Carla Mann Koskinas, PA-C

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.