CHARLENE KOENIG (MA) – Mental Health Counselor, NPI 1053194068

CHARLENE KOENIG (MA) is a healthcare provider. based in Goshen, Indiana. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA. They hold a License No. 88002034A (IN). The NPI Number for CHARLENE KOENIG (MA) is 1053194068

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
CHARLENE KOENIG (MA)
NPI
1053194068
Phone
(574) 533-1234
Address
330 LAKEVIEW DR
Enumeration Date
15 August 2023
Last Update Date
15 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5745331234
Graduation Year
2013 (13 years ago)
PAC ID
4082114814
Group Practice PAC ID
6002801065
Professional Enrollment ID
I20250825004000
Address ID
IN465289365GO330XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

893 MENTAL HEALTH COUNSELOR in IN

Provider Addresses for CHARLENE KOENIG (MA)

  • 330 LAKEVIEW DR

    GOSHEN, IN 465287000

    Phone: (574) 533-1234

    Fax: (574) 537-2652

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250825004000IMental Health CounselorINTBD
I20251209001204IMental Health CounselorSCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46528)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002801065View full group profile
NameSpecialtyState
-IN
Clinical Social WorkerIN
Clinical Social WorkerIN
-IN
P S Y C H I A T R YIN
Clinical PsychologistIN
Nurse PractitionerIN
Clinical Social WorkerIN
Nurse PractitionerIN
-IN

Reviews

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Frequently asked questions

Can I cross-check CHARLENE KOENIG (MA) using NPI 1053194068?
NPI 1053194068 belongs to CHARLENE KOENIG (MA); compare other details if you need extra assurance.
Is CHARLENE KOENIG (MA) still an active registrant?
CHARLENE KOENIG (MA) carries an active NPI according to the public dataset.
What kind of doctor is CHARLENE KOENIG (MA)?
CHARLENE KOENIG (MA) is associated with Mental Health Counselor in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with CHARLENE KOENIG (MA)?
Directory geography for CHARLENE KOENIG (MA) centers on Goshen, Indiana.
Can I trust this NPI listing for CHARLENE KOENIG (MA)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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