Heidemarie Koop
Individual provider Active NPI Clinical Social Worker · Captain Cook, HI
NPI 1700051117 · NPPES record last updated Nov 4, 2015
Key facts
- NPI
- 1700051117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW - 3268 (HI)
- Practice address
- 81-6161 D Road
Captain Cook, HI 96704 - Phone
- (808) 987-2296
- NPI assigned
- Apr 25, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151113001940 | HI | Practitioner - Clinical Social Worker | 9537474457 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW - 3268 | HI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heidi Koop Counseling and Consulting LLC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW - 3268 | HI | Yes |
Addresses
Primary practice location
81-6161 D Road
Captain Cook, HI 96704
Mailing address
75-5744 Alii Dr 237
Kailua Kona, HI 96740-1740
Phone (808) 987-2296
Other providers in Captain Cook, HI
- Lori Gill
- Athena D Gray
- Heidi Koop Counseling and Consulting LLC
- Renee Catherine Hoadley
- Linda Chiu Hole
- Kenneth Arthur Kotner
- Thomas Langenstein
- Christopher Leimbach
- Uala Lenta
- Leon Matsuo MD Inc
All providers in Captain Cook, HI · Clinical Social Worker in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.