Kevin Ross Koelsch, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61488824 Issued in WA

Practice address

3430 E Highway 101
Port Angeles, WA 98362-9068

Phone

(360) 452-4062

Fax

(360) 452-4189

NPI assigned

Oct 31, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Reflections Counseling Services Group

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Port Angeles, WA
  • NPI 1740569664
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1083487102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 E HIGHWAY 101",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983629068",
            "telephone_number": "360-452-4062",
            "fax_number": "360-452-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 E HIGHWAY 101",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983629068",
            "telephone_number": "360-452-4062",
            "fax_number": "360-452-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELSCH",
        "first_name": "KEVIN",
        "middle_name": "ROSS",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61488824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kloth, PAC
• Julianne Diana Knezovich, PA-C
• Robert Lowell Knipple, D.D.S.
• Amanda Knobel
• Julie K Knobel, LICSW
• Cheryl Dawn Koenig, LMP
• Sarah Camile Komatsu, MS, MHP, LMHC
• John Kopp
• Betsy L Kott-Flodstrom, MD
• Bradley Mark Krall, PA-C

• Addiction (Substance Use Disorder) Counselor in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.