Individual provider Active NPI

David Koepnick, MA, LAPC, CAMS-II

  • Professional Counselor
  • Athens, GA
National Provider Identifier
1467044362
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC014879 Issued in GA
Practice address
644 N Chase St # 104
Athens, GA 30601-1960
Phone
(706) 898-3276
NPI assigned
Feb 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC014879 GA Primary

Addresses

Primary practice location

644 N Chase St # 104
Athens, GA 30601-1960

Mailing address

158 Oak Meadow Dr
Athens, GA 30605-4550
Phone (706) 765-7512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20250113001851 GA Practitioner - Mental Health Counselor 4284162637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

644 N Chase St
Suite 104
Athens, GA 30601-1960
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Dec 17, 2024 Accepting new patients
Advantage Behavioral Health Systems PastSince Feb 1, 2021 Accepting new patients

Locations

644 N Chase St
Ste 104
Athens, GA 30601
Phone (706) 898-3276

8800 Roswell Rd
Ste A135
Sandy Springs, GA 30350
Phone (617) 395-5806

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1467044362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 OAK MEADOW DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306054550",
            "telephone_number": "706-765-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 N CHASE ST # 104",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306011960",
            "telephone_number": "706-898-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPNICK",
        "first_name": "DAVID",
        "credential": "MA, LAPC, CAMS-II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.