Active NPI
Danielle Koeneman, LPC
- Mental Health Counselor
- Shiloh, IL
National Provider Identifier
1952178402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1941 Frank Scott Pkwy E Ste C
Shiloh, IL 62269-7387 - Phone
- (618) 942-1568
- Fax
- (618) 205-3561
- NPI assigned
- Dec 5, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1941 Frank Scott Pkwy E Ste C
Shiloh, IL 62269-7387
Mailing address
3 Oak Dr Ste B
Maryville, IL 62062-5635
Phone (618) 974-5815
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counselors Associates | Current | Accepting new patients | |
| New Leaf Counseling Services, LLC | Past | Accepting new patients |
Locations
3 Oak Dr
#B
Maryville, IL 62062
Phone (618) 972-1568
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 and National Provider Directory roles.
-
- Professional Counselor
- Maryville, IL
- NPI 1922399682
-
- Community/Behavioral Health Agency
- Glen Carbon, IL
- NPI 1104101732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1952178402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 OAK DR STE B",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625635",
"telephone_number": "618-974-5815",
"fax_number": "618-205-3561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1941 FRANK SCOTT PKWY E STE C",
"city": "SHILOH",
"state": "IL",
"postal_code": "622697387",
"telephone_number": "618-942-1568",
"fax_number": "618-205-3561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENEMAN",
"first_name": "DANIELLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-05",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shiloh, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.