Active NPI
Terra Koenig, LMSW
- Social Worker
- Centreville, MI
National Provider Identifier
1467970004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801100896
- Practice address
- 677 E Main Street
Centreville, MI 49032 - Phone
- (269) 467-1000
- NPI assigned
- Sep 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801100896 | MI | Primary |
Addresses
Primary practice location
677 E Main Street
Centreville, MI 49032
Mailing address
677 E Main St
Centreville, MI 49032-8524
Phone (269) 503-9945
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801100896 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1467970004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 E MAIN ST",
"city": "CENTREVILLE",
"state": "MI",
"postal_code": "490328524",
"telephone_number": "269-503-9945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 E MAIN STREET",
"city": "CENTREVILLE",
"state": "MI",
"postal_code": "49032",
"telephone_number": "269-467-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "TERRA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801100896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centreville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.