Individual provider Active NPI

Keni P Koon, M.ED.

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1497160188
Registry record updated Jun 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 11170 Issued in FL
Practice address
1485 S Semoran Blvd
Suite 1448
Winter Park, FL 32792-5533
Phone
(321) 397-3000
NPI assigned
Jun 22, 2014
Last updated
Jun 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH 11170 FL Primary

Addresses

Primary practice location

1485 S Semoran Blvd
Suite 1448
Winter Park, FL 32792-5533

Mailing address

1485 S Semoran Blvd
Suite 1448
Winter Park, FL 32792-5533
Phone (321) 397-3000

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
IMH 11170FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1403395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403395200000",
    "number": "1497160188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 S SEMORAN BLVD",
            "address_2": "SUITE 1448",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327925533",
            "telephone_number": "321-397-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 S SEMORAN BLVD",
            "address_2": "SUITE 1448",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327925533",
            "telephone_number": "321-397-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "KENI",
        "middle_name": "P",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-22",
        "last_updated": "2014-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 11170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2014; 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.