MRS. TORY PHONSAVAN KOETTERHAGEN (NPI# 1093281370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093281370 |
| Entity Type | Individual |
| Full Name | MRS. TORY PHONSAVAN KOETTERHAGEN |
| Credential | LCSW |
| Practice Address |
W236s4564 Whispering Hills Ct Waukesha WI 53189-9772 |
| Practice Telephone | 4144676994 |
| Mailing Telephone | 4144676994 |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
8075-123 | WI | Behavioral Health & Social Service Providers |
| Street Address |
W236S4564 WHISPERING HILLS CT |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53189-9772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275017907 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1166 W Sunset Drive, Suite F100, Waukesha, WI 53189 | 2018-09-19 |
| 1851841910 | Jane Knoblock | Speech-Language Pathologist | S48w23663 Merlin Ln, Waukesha, WI 53189 | 2016-10-12 |
| 1063850246 | Tracey Sue Kochanski | Nurse Practitioner | 1130 W Sunset Ave, Waukesha, WI 53189 | 2013-06-10 |
| 1376981811 | Mark Russell Schmitt | Registered Nurse | 1804 Dixie Dr., Waukesha, WI 53189 | 2013-06-06 |
| 1760738546 | Schreve and Associates Inc. | Durable Medical Equipment & Medical Supplies | 406 Travis Ln., Ste 50, Waukesha, WI 53189 | 2012-07-30 |
| 1407152879 | Kimberly Lyn Moravec | Registered Nurse | W326 S3994 Spring Ridge Ct, Waukesha, WI 53189 | 2011-02-02 |
| 1154505113 | Le Ann Le Blanc | Day Training, Developmentally Disabled Services | S31 W28251 Sunset Drive, Waukesha, WI 53189 | 2007-12-26 |
| 1801934807 | Wisconsin Vision, Inc. | Technician/Technologist | 203a Sunset Drive, Waukesha, WI 53189 | 2007-02-02 |
| 1497828172 | Donna G. Kraklow D.d.s. | Dentist | 1507 E Sunset Dr, Suite 110, Waukesha, WI 53189 | 2006-11-17 |
| 1285713461 | Robert Evan Davies | Dentist | 2117 Corporate Dr., Suite 100, Waukesha, WI 53189 | 2006-11-06 |
| Find all providers in zip 53189 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831670 | Sarah Penke | Social Worker | 1895 Haymarket Rd Apt 90, Waukesha, WI 53189-8507 | 2020-05-05 |
| 1902444029 | Ashley Westphal | Social Worker | 422 Hillview Cir, Waukesha, WI 53188-3228 | 2019-12-19 |
| 1861876138 | Nathan Amos | Social Worker | 1515 Paramount Dr, Waukesha, WI 53186-3959 | 2015-07-16 |
| 1598142937 | Sophia Marie Klingbiel | Social Worker | 1515 Paramount Dr., Waukesha, WI 53186 | 2015-05-06 |
| 1871998070 | Candace Lynn Williams | Social Worker | 2046 Cliff Alex Ct S Apt 3, Waukesha, WI 53189-8100 | 2014-10-30 |
| 1104975341 | Douglas Meske | Social Worker | 2607 N Grandview Blvd Ste 110, Waukesha, WI 53188 | 2007-01-09 |
| 1023170099 | Jerome Michael Loberg | Social Worker | 1501 Airport Rd., Waukesha, WI 53188 | 2006-12-15 |
| 1952416034 | Jennifer Foro | Social Worker | W231 N1440 Corporate Ct, #310, Waukesha, WI 53186 | 2006-08-20 |
| 1629099700 | Dennis Rody | Social Worker | 400 W Moreland Blvd, Waukesha, WI 53188-2412 | 2006-07-22 |
| 1578554747 | Kimberley Hollander Fischer | Social Worker | 500 Riverview Avenue, Waukesha, WI 53188-4809 | 2005-11-04 |
| Find all providers in WAUKESHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.