Koinonia Behavioral Health, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KOINONIA BEHAVIORAL HEALTH, LLC

Practice address

6161 Oak Tree Blvd Ste 230
Independence, OH 44131-2581

Phone

(216) 588-8777

NPI assigned

May 23, 2022

Organization subpart

Yes

Parent organization

KOINONIA HOMES, INC.As reported in NPPES

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

Authorized official

Name

Brian Hoyer

Title

Director of Quality & Compliance

Phone

(216) 588-8777

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Koinonia Homes Inc

Locations

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1891433637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 OAK TREE BLVD STE 400",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312581",
            "telephone_number": "216-588-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 OAK TREE BLVD STE 230",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312581",
            "telephone_number": "216-588-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOINONIA BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOINONIA HOMES, INC.",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "HOYER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DIRECTOR OF QUALITY & COMPLIANCE",
        "authorized_official_telephone_number": "216-588-8777"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407334824",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charel Lee Khol, PH.D.
• Alex Kinser
• Duane E Kirksey, MD
• Ashley Knight, LSW
• Bethany Ann Koch, SLP
• Koinonia Community Services LLC
• Koinonia Community Services LLC
• Koinonia Enterprises LLC
• Koinonia Homes, Inc
• Koinonia Partners Unlimited LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Independence, OH
• Providers in Independence, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.