Peter Koehn, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301016953 Issued in MI

Practice address

4032 Lindberg Ave NE
Grand Rapids, MI 49525-1451

Phone

(616) 570-5056

NPI assigned

Jul 7, 2008

Last updated

Jun 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

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.

• Cognitive Care Counseling, PLLC

  • Clinical Social Worker
  • Huntley, IL
  • NPI 1013532191
  NPD (past)

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1487817789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4032 LINDBERG AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251451",
            "telephone_number": "616-570-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4032 LINDBERG AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251451",
            "telephone_number": "616-570-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007428",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Finley Kocher, D.O.
• Sarah Kocsis, M.DIV, M.A., LLC
• Kodde Counseling, LLC (Begin Anew Counseling)
• Jan Koebbe, NP
• Morgan Elizabeth Koehler, OTR/L
• Robert Koeller, DPT
• Jessica Koelling
• Molly Koelzer, MA, LLC
• Teresa M Koelzer, CRNA
• Mary Koenen, F.N.P.

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.