Provider Demographics
NPI:1851808422
Name:KOERNER, JOYCE (LADC)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:KOERNER
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:914 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-3133
Mailing Address - Country:US
Mailing Address - Phone:651-285-0611
Mailing Address - Fax:
Practice Address - Street 1:1027 7TH ST NW STE 205
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2666
Practice Address - Country:US
Practice Address - Phone:507-281-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MN305007101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health