RANDALL KOCH (MS, LPC) – Professional Counselor, NPI 1336563311

RANDALL KOCH (MS, LPC) is a healthcare provider. based in Petoskey, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MS, LPC. They hold a License No. 6401012477 (MI). The NPI Number for RANDALL KOCH (MS, LPC) is 1336563311

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
RANDALL KOCH (MS, LPC)
NPI
1336563311
Phone
(231) 347-5511
Address
704 EMMET ST
Enumeration Date
11 February 2014
Last Update Date
11 February 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2312421700
Graduation Year
1988 (38 years ago)
PAC ID
6901318500
Group Practice PAC ID
8820995368
Professional Enrollment ID
I20250620000203
Address ID
MI497708330PE1260XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:12State licenses:2Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for RANDALL KOCH (MS, LPC)

  • 704 EMMET ST

    PETOSKEY, MI 497702910

    Phone: (231) 347-5511

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2025-06-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20250620000203IMental Health CounselorMITBD

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 49770)

Loading plans...

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: 8820995368View full group profile
NameSpecialtyState
Mental Health CounselorMI
Clinical Social WorkerMI
-MI
Family PracticeMI
Clinical Social WorkerMI
Clinical PsychologistMI
Pediatric MedicineMI
Clinical Social WorkerMI
Family PracticeMI
Family PracticeMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I cross-check RANDALL KOCH (MS, LPC) using NPI 1336563311?
NPI 1336563311 belongs to RANDALL KOCH (MS, LPC); compare other details if you need extra assurance.
Is RANDALL KOCH (MS, LPC) still an active registrant?
RANDALL KOCH (MS, LPC) carries an active NPI according to the public dataset.
How would a patient describe RANDALL KOCH (MS, LPC)'s focus?
For RANDALL KOCH (MS, LPC), the primary taxonomy reads as Professional Counselor. Clinical services aligned with this taxonomy classification.
Where in Michigan is RANDALL KOCH (MS, LPC) registered?
Use Petoskey, Michigan as the headline location for RANDALL KOCH (MS, LPC) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.