Susan L Koepnick, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC-3103 Issued in ID

Practice address

2311 Park Ave
Unit 3 Suite 12
Burley, ID 83318-2170

Phone

(208) 678-3555

Fax

(208) 678-3556

NPI assigned

Nov 1, 2007

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

Other identifiers 1

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1407035959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 WAUNA VISTA DR",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833183447",
            "telephone_number": "208-731-1711",
            "fax_number": "208-678-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 PARK AVE",
            "address_2": "UNIT 3 SUITE 12",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182170",
            "telephone_number": "208-678-3555",
            "fax_number": "208-678-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPNICK",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LPC-3103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IDAHO",
            "identifier": "LPC-3103",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane Ryan Kelsey, MS, LPC
• Kevin D. Banner
• Michael P Klett, D.O.
• Kaity Kobayashi, PT, DPT, PCS
• Heidi Lee Koepnick, LPC
• Karrie Rae Kondel, ARNP
• Seth Koyle
• Mary Kraemer
• Evan Kress, PT
• Brett Jack Lancaster, D.M.D

• Counselor in Burley, ID
• Providers in Burley, ID by specialty
• Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.