William Michael Koch, LPC
Individual provider Active NPI Professional Counselor · Odessa, MO
NPI 1629419015 · NPPES record last updated Oct 22, 2020
Key facts
- NPI
- 1629419015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2013022744 (MO)
- Practice address
- 416 East Chestnut Street
Odessa, MO 64076-1580 - Phone
- (660) 229-0728
- NPI assigned
- Jul 12, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013022744 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Counseling & Training LLC | Professional | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2013022744 | MO | Yes |
Addresses
Primary practice location
416 East Chestnut Street
Odessa, MO 64076-1580
Mailing address
416 East Chestnut Street
Odessa, MO 64076-1580
Phone (660) 229-0728
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629415015 | Medicaid | MO |
Other providers in Odessa, MO
- Hypnotic Impact Coaching, LLC
- Inspired Body Therapy LLC
- Frederick Leon Johnson Jr.
- Timothy A Kesemann
- Meghan Elizabeth Klaas
- Shanna Lapinski
- Vanessa Lawrence
- Brandi Suzanne Leslie
- Melanie Logan
- Malinda Gann Lowery
All providers in Odessa, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.