Individual provider Active NPI

William Jackson Koehler, LCSW

  • Clinical Social Worker
  • Erie, PA
National Provider Identifier
1699904227
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016123 Issued in PA
Practice address
201 W 11TH St
Erie, PA 16501-1701
Phone
(814) 397-7480
NPI assigned
Jul 2, 2009
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW016123 PA Primary

Addresses

Primary practice location

201 W 11TH St
Erie, PA 16501-1701

Mailing address

910 Plum St
Erie, PA 16502-1245
Phone (814) 397-7480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20110914000067 PA Practitioner - Clinical Social Worker 8921279456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 W 11TH St
Erie, PA 16501-1701
Phone (833) 487-5769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Journey to a Trauma-Informed Life CurrentSince Jun 19, 2020 Accepting new patients
Persad Center, Inc. PastSince Aug 15, 2014 Accepting new patients

Locations

201 W 11th St
Erie, PA 16501
Phone (814) 397-7480

2230 W 8th St
Ste 2
Erie, PA 16505
Phone (814) 516-2440

3104 State St
Erie, PA 16508
Phone (814) 431-4553

Interoperability endpoints

  • Direct secure messaging: william.koehler.2@19587.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1699904227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 PLUM ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165021245",
            "telephone_number": "814-397-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W 11TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011701",
            "telephone_number": "814-397-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "WILLIAM",
        "middle_name": "JACKSON",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.