Provider Demographics
NPI:1275635567
Name:KOERNER, JODY K (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:JODY
Middle Name:K
Last Name:KOERNER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 SW SOUTH POINTE DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:KS
Mailing Address - Zip Code:66402-9533
Mailing Address - Country:US
Mailing Address - Phone:785-249-4847
Mailing Address - Fax:785-478-3509
Practice Address - Street 1:6109 SW SOUTH POINTE DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:KS
Practice Address - Zip Code:66402-9533
Practice Address - Country:US
Practice Address - Phone:785-249-4847
Practice Address - Fax:785-785-4783
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16671041C0700X
KSLSCSW16671041C0700X
KSLSCSW 16671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical