Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Pamela Jean Koonz, LCSWCSAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1518006667

MS. Pamela Jean Koonz, LCSWCSAC is a Clinical Social Worker in Racine, Wisconsin. Qualified in 1985, 41 years ago. Practices with Lakeside Family Therapy Services Ltd, a 2-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
41
Licensed in
WI
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

4810 Northwestern Ave
Racine, WI 53406
Phone: (262) 637-9984
Fax: (262) 637-9995
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 1298132 (WI)
Social Worker Taxonomy 104100000X · Licence 3908123 (WI)

Record details

NPI number1518006667
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSWCSAC
Sole proprietorNo
NPI enumeratedFebruary 5, 2007
Last updated in NPPESSeptember 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Group practice Lakeside Family Therapy Services Ltd — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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