Tyler Koontz, LSW
Social Worker in Champaign, IL. Individual provider (NPI-1).
NPI number1649699786
StatusActive
Last updated in NPPESMay 7, 2020
Details
- NPI
- 1649699786
- Entity type
- Individual (NPI-1)
- Name
- Tyler Koontz
- Credential
- LSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 15, 2014
- Certification date
- May 7, 2020
- Last updated
- May 7, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | – | – | Yes |
Practice location
309 W Clark StChampaign, IL 61820-4637
Phone 217-398-9066
Mailing address
309 W Clark StChampaign, IL 61820-4637
Other practice locations
801 N Walnut St
Champaign, IL 61820-3055
Champaign, IL 61820-3055
Phone 217-373-2430
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 275 Social Worker providers in Champaign · All 3,018 providers in Champaign
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