Individual
KENNETH KOYM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.F.T., CE PROVIDER
Contact information
Practice address
9704 MONARCH LN, AUSTIN, TX 78724-5840
(512) 215-4798
Mailing address
9704 MONARCH LN, AUSTIN, TX 78724-5840
(512) 215-4798
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
2646
TX
174400000X
Specialist
Primary
05-060-B (TEA)
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00165
BCBS IN MEXICO & TX
TX
05
—
02596810
—
TX
01
—
11824054
R & S NUMBER
TX
01
—
1240
STATEBARTX CE PRVDR #
TX
01
—
562
AMBARASSNCEPRVDR #
TX
01
—
LP0005392
# MAYBE MEDICARE
TX
Enumeration date
10/18/2006
Last updated
09/11/2025
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