Stacy Anne Koch, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.025337 Issued in IL

Practice address

1800 Hollister Dr Ste 201
Libertyville, IL 60048-5266

Phone

(847) 549-1189

NPI assigned

Feb 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Green Fields Therapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northbrook, IL
  • NPI 1306791843
  NPD Authorized official

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1427757749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 LAUREL AVE",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154782",
            "telephone_number": "773-294-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR STE 201",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485266",
            "telephone_number": "847-549-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "STACY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801122404",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Kliska, OTR/L
• Allison Klotzbuecher, D.O.
• Paulina Kluchka
• Madeline Knoll, LCSW
• Robert J Koch, DO
• Michael Bernard Kocher, LCSW
• Koffel Medical Supply Inc
• Candia A. Koleszar, RPH
• Karyn Kolner, DPT
• Tina Kolovos, PHARMD

• Clinical Social Worker in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.