JEFFREY KOENIG (LISW) – Mental Health Counselor, NPI 1750636254

JEFFREY KOENIG (LISW) is a healthcare provider. based in Galena, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. I-4377 (OH). The NPI Number for JEFFREY KOENIG (LISW) is 1750636254

Main info

Male
Sole Proprietor
39 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY KOENIG (LISW)
NPI
1750636254
Phone
(614) 349-1288
Address
11880 GORSUCH RD
Enumeration Date
20 July 2012
Last Update Date
29 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7408773440
Graduation Year
1987 (39 years ago)
PAC ID
8022269893
Group Practice PAC ID
7810217536
Professional Enrollment ID
I20121105000352
Address ID
OH430561647HE575XXPKWY300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

Provider Addresses for JEFFREY KOENIG (LISW)

  • 11880 GORSUCH RD

    GALENA, OH 430219669

    Phone: (614) 349-1288

    Type: Mailing

  • 3838 BROADWAY

    GROVE CITY, OH 431232234

    Phone: (614) 801-1812

    Fax: (614) 801-1814

    Type: Mailing

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: 2012-11-05

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
I20121105000352IClinical Social WorkerOHTBD

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 43021)

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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: 7810217536View full group profile
NameSpecialtyState
Mental Health CounselorOH
Clinical PsychologistOH
Mental Health CounselorOH
Clinical Social WorkerOH
Clinical Social WorkerOH
Mental Health CounselorOH
Mental Health CounselorOH
Nurse PractitionerOH
Clinical PsychologistOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

What is JEFFREY KOENIG (LISW)'s NPI number?
JEFFREY KOENIG (LISW)'s NPI is 1750636254 — the number used across U.S. healthcare to identify this provider.
Is JEFFREY KOENIG (LISW) shown as active in public data?
Registry records indicate JEFFREY KOENIG (LISW) maintains an active NPI.
What kind of doctor is JEFFREY KOENIG (LISW)?
JEFFREY KOENIG (LISW) is associated with Mental Health Counselor in the directory — Clinical services aligned with this taxonomy classification.
Is JEFFREY KOENIG (LISW) located near Galena?
JEFFREY KOENIG (LISW) currently maps to Galena, Ohio in this extract.
When was this NPI issued?
Enumeration for JEFFREY KOENIG (LISW) is noted as July 20, 2012 where the registry provides it.

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