Tanya Renee Koelker, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180011458 Issued in IL

Practice address

12 Sundew Dr
Belleville, IL 62221-4356

Phone

(618) 581-8802

NPI assigned

Aug 19, 2024

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

Enrolled in IL

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kaleidoscope Heart Counseling, LLC

  • Professional Counselor
  • Belleville, IL
  • NPI 1376378562
  Medicare reassignment NPD Authorized official
• New Seasons Counseling

  • Community/Behavioral Health Agency
  • Belleville, IL
  • NPI 1255104212
  NPD

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1902638653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LINCOLN PLACE CT STE 102",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215876",
            "telephone_number": "618-722-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SUNDEW DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622214356",
            "telephone_number": "618-581-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELKER",
        "first_name": "TANYA",
        "middle_name": "RENEE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Steven Knox, D.M.D.
• Susan E Kober, RD
• Matthew J Koch, MD
• Kaitlin Kocher, LAT, ATC
• Andrea H Koehler, PT
• Maria Koesterer, RPH
• Elizabeth Vollmer Kohler, LPC
• Jill Aberdeen Kolchinsky, FNP-BC
• Michelle C Kolman, RPH
• Komeshak Chiropractic LTD

• Professional Counselor in Belleville, IL
• Providers in Belleville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.