Michele Suzanne Koonin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LL10793 Issued in CA

Practice address

2725 Congress St Ste 2C
San Diego, CA 92110-2767

Phone

(619) 688-1035

Fax

(619) 688-1098

NPI assigned

Jul 5, 2006

Last updated

Apr 11, 2014By the provider in NPPES

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 CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Cifc Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1538781190
  Authorized official Same address or phone
• Institute for Counseling Inc

  • Clinical Social Worker
  • San Diego, CA
  • NPI 1598023475
  Authorized official Same address or phone

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1982635611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 CONGRESS ST STE 2C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102767",
            "telephone_number": "619-688-1035",
            "fax_number": "619-688-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CONGRESS ST STE 2C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102767",
            "telephone_number": "619-688-1035",
            "fax_number": "619-688-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONIN",
        "first_name": "MICHELE",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LL10793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Kooima, RN
• Eloise Kae Kooima
• Gayle Michelle Kookootsedes, M.D.
• Jejo D. Koola, MD
• Danae Elizabeth Koolen, L.AC.
• Melissa C Koonings, CRNA
• Paul P. Koonings, MD
• Dwight Hunter Koontz II, IDC
• Michaela Elizabeth Koontz
• Nancy J Koontz, NP

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.