Individual provider Active NPI

Jill Koehn, LPC

  • Mental Health Counselor
  • Arroyo Grande, CA
National Provider Identifier
1841499464
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2427 Issued in CO
Practice address
251 Walnut St
Arroyo Grande, CA 93420-3111
Phone
(307) 220-3408
NPI assigned
Jul 13, 2007
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 329 WY
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD671 CO
Mental Health Counselor 101YM0800X 841 WY
Mental Health Counselor 101YM0800X CCMH0183381 NM
Mental Health Counselor 101YM0800X 2427 CO Primary

Addresses

Primary practice location

251 Walnut St
Arroyo Grande, CA 93420-3111

Mailing address

251 Walnut St
Arroyo Grande, CA 93420-3111
Phone (307) 220-3408

Other identifiers 1

IdentifierTypeStateIssuer
48984299MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD671COMDAddiction (Substance Use Disorder) Counselor
329WYMDAddiction (Substance Use Disorder) Counselor
CCMH0183381NMMDMental Health Counselor
841WYMDMental Health Counselor
2427COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Unlimited Psychology, LLC Mental Health PastSince Nov 20, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jillkoehn@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1841499464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 WALNUT ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203111",
            "telephone_number": "307-220-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 WALNUT ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203111",
            "telephone_number": "307-220-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "JILL",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "329",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD671",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "841",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CCMH0183381",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "2427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48984299",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

Verify at the official NPI Registry.