Kathryn E Koenig-Leuck, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3757-57 Issued in WI

Practice address

1205 S 70TH St Ste 301
West Allis, WI 53214-3171

Phone

(414) 475-2788

Fax

(414) 476-8695

NPI assigned

Aug 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kathryn E Koenig Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Professional Services Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1619024262
  Medicare reassignment NPD
• Milwaukee Behavioral Health LLC

  • Psychiatric Hospital
  • Milwaukee, WI
  • NPI 1497324115
  NPD

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1679098743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S 70TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143167",
            "telephone_number": "414-475-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S 70TH ST STE 301",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143171",
            "telephone_number": "414-475-2788",
            "fax_number": "414-476-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG-LEUCK",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6571",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3757-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "KOENIG",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Knight Vision & Glaucoma Specialists, Inc.
• Eric L. Knight, O.D.
• John Paul Knoop, SAC
• Knueppel Healthcare Services, Inc.
• Elizabeth Laura Koenen, M.S. CCC-SLP
• Hana Koester
• Heidi J Kohler, PA-C
• Ruth A Kohnke
• Nicholas Kolatski, LPC-IT
• Alix F Komar, M.D.

• Psychologist in West Allis, WI
• Providers in West Allis, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.