Gregory J Koehler, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

880-123 Issued in WI

Practice address

6629 University Ave Ste 209
Middleton, WI 53562-3037

Phone

(608) 833-5880

Fax

(608) 829-3787

NPI assigned

Jul 23, 2021

Last updated

Jul 23, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Counseling Center of Madison, Wi, Inc.

  • Mental Health Counselor
  • Middleton, WI
  • NPI 1003936899
  NPD (past)

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1417520750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6629 UNIVERSITY AVE STE 209",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623037",
            "telephone_number": "608-833-5880",
            "fax_number": "608-829-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6629 UNIVERSITY AVE STE 209",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623037",
            "telephone_number": "608-833-5880",
            "fax_number": "608-829-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "880-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "counseling@communitycounselingmadison.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6629 University Ave Ste 209",
            "city": "Middleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535623037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gary Mark Kirk, M.D., M.P.H.
• Jessica Ann Taapken Klabough, MFT
• Malinda Kleemann
• Tracy A Klein, O.D.
• Andrea Klopp
• Matthew Koester, DPT
• Karen Ann Kohls, PT
• Valeria Kolison
• Emily Komoroske, P.T.
• Kelsey Leigh Kornaus, OTR

• Social Worker in Middleton, WI
• Providers in Middleton, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.