| Lawson Koeppel Llc | |
|
1701 Grandin Rd Sw Roanoke VA 24015-2815 | |
| (540) 524-2114 | |
| Not Available |
| Full Name | Lawson Koeppel Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1701 Grandin Rd Sw, Roanoke, Virginia |
| Authorized Official Name and Position | Lawson Koeppel (OWNER) |
| Authorized Official Contact | 5405242114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawson Koeppel Llc 622 Allison Ave Sw Apt 3 Roanoke VA 24016-4549 Ph: () - | Lawson Koeppel Llc 1701 Grandin Rd Sw Roanoke VA 24015-2815 Ph: (540) 524-2114 |
| NPI Number | 1952137481 |
|---|---|
| Provider Enumeration Date | 09/11/2024 |
| Last Update Date | 09/11/2024 |
| Certification Date | 09/11/2024 |
| Medicare PECOS PAC ID | 0648705699 |
|---|---|
| Medicare Enrollment ID | O20241127001386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952137481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lawson William Koeppel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689338758 PECOS PAC ID: 2466987417 Enrollment ID: I20241127001512 |
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