Active NPI
Alyssa Koch, L.CSW
- Clinical Social Worker
- Delray Beach, FL
National Provider Identifier
1619355146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 12785
- Practice address
- 500 Gulfstream Blvd Ste 105
Delray Beach, FL 33483-6142 - Phone
- (954) 609-5638
- Fax
- (877) 281-1665
- NPI assigned
- May 17, 2015
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 12785 | FL | Primary |
Addresses
Primary practice location
500 Gulfstream Blvd Ste 105
Delray Beach, FL 33483-6142
Mailing address
500 Gulfstream Blvd Ste 105
Delray Beach, FL 33483-6142
Phone (954) 609-5638
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 12785 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431820800000",
"number": "1619355146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 GULFSTREAM BLVD STE 105",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334836142",
"telephone_number": "954-609-5638",
"fax_number": "877-281-1665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 GULFSTREAM BLVD STE 105",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334836142",
"telephone_number": "954-609-5638",
"fax_number": "877-281-1665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "ALYSSA",
"name_prefix": "Ms.",
"credential": "L.CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-17",
"last_updated": "2015-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 12785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delray Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.