Jessica Koep, MSW, LGSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24858 Issued in MN

Practice address

595 Selby Ave
Saint Paul, MN 55102-1730

Phone

(214) 403-5052

NPI assigned

Jul 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500768000000",
    "number": "1780107672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1986 LEE ST",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551172231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021730",
            "telephone_number": "214-403-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEP",
        "first_name": "JESSICA",
        "credential": "MSW, LGSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2017-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas E Koehntop, MD
• Megan Koelln
• Ryan J Koene, M.D.
• Danielle Koenig, CNP
• Lisa F Koenig, MD
• Evajane Koeper
• Laconia Koerner, L.AC.
• Rebecca M Koerner, MD
• Andrea Susan Kofoed, LADC
• Julie Ann Kogan-White, M.A.

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.