Individual provider Active NPI

Janet Marie Koelsch, LCSW-C

  • Clinical Social Worker
  • Columbia, MD
National Provider Identifier
1417385253
Registry record updated Aug 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11094 Issued in MD
Practice address
6520 Wingflash LN
Columbia, MD 21045-4641
Phone
(410) 245-5316
Fax
(410) 309-1797
NPI assigned
Oct 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11094 MD Primary

Addresses

Primary practice location

6520 Wingflash LN
Columbia, MD 21045-4641

Mailing address

6520 Wingflash LN
Columbia, MD 21045-4641
Phone (410) 245-5316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11094MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438387200000",
    "number": "1417385253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 WINGFLASH LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454641",
            "telephone_number": "410-245-5316",
            "fax_number": "410-309-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 WINGFLASH LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454641",
            "telephone_number": "410-245-5316",
            "fax_number": "410-309-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELSCH",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-14",
        "last_updated": "2015-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2015; 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.