Active NPI
Alison B Koehler, LCPC
- Mental Health Counselor
- Gurnee, IL
National Provider Identifier
1700935418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 04932302
- Practice address
- 4343 Old Grand Ave
Suite 107 C
Gurnee, IL 60031-2767 - Phone
- (847) 924-4793
- Fax
- (847) 865-0867
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 04932302 | IL | Primary |
Addresses
Primary practice location
4343 Old Grand Ave
Suite 107 C
Gurnee, IL 60031-2767
Mailing address
17540 W Westwind Dr
Gurnee, IL 60031-1691
Phone (847) 924-4793
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04932302 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700935418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17540 W WESTWIND DR",
"city": "GURNEE",
"state": "IL",
"postal_code": "600311691",
"telephone_number": "847-924-4793",
"fax_number": "847-856-0867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4343 OLD GRAND AVE",
"address_2": "SUITE 107 C",
"city": "GURNEE",
"state": "IL",
"postal_code": "600312767",
"telephone_number": "847-924-4793",
"fax_number": "847-865-0867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEHLER",
"first_name": "ALISON",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "04932302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.