Active NPI
Kenneth Koym, M.F.T., CE PROVIDER
- Specialist
- Austin, TX
National Provider Identifier
1770664526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 05-060-B (TEA)
- Practice address
- 9704 Monarch LN
Austin, TX 78724-5840 - Phone
- (512) 215-4798
- NPI assigned
- Oct 18, 2006
- Last updated
- Sep 13, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2646 | TX | |
| Specialist | 174400000X | 05-060-B (TEA) | TX | Primary |
Addresses
Primary practice location
9704 Monarch LN
Austin, TX 78724-5840
Mailing address
9704 Monarch LN
Austin, TX 78724-5840
Phone (512) 215-4798
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02596810 | Medicaid | TX | |
| 562 | Other | TX | AMBARASSNCEPRVDR # |
| LP0005392 | Other | TX | # MAYBE MEDICARE |
| 1240 | Other | TX | STATEBARTX CE PRVDR # |
| 00165 | Other | TX | BCBS IN MEXICO & TX |
| 11824054 | Other | TX | R & S NUMBER |
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 |
|---|---|---|---|
| 2646 | TX | MD | Marriage & Family Therapist |
| 05-060-B (TEA) | TX | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dialogue-Producing Consortium | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- Austin, TX
- NPI 1497813372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789257600000",
"number": "1770664526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9704 MONARCH LN",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787245840",
"telephone_number": "512-215-4798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9704 MONARCH LN",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787245840",
"telephone_number": "512-215-4798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOYM",
"first_name": "KENNETH",
"credential": "M.F.T., CE PROVIDER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2026-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "2646",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "05-060-B (TEA)",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02596810",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMBARASSNCEPRVDR #",
"identifier": "562",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "# MAYBE MEDICARE",
"identifier": "LP0005392",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATEBARTX CE PRVDR #",
"identifier": "1240",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IN MEXICO & TX",
"identifier": "00165",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R & S NUMBER",
"identifier": "11824054",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.