Individual provider Active NPI

Michael Allan-Joseph Colin, LPC, LMAC, CTP, NCC

  • Mental Health Counselor
  • Overland Park, KS
National Provider Identifier
1104506716
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3543 Issued in KS
Practice address
8575 W 110TH St # 208
Overland Park, KS 66210-1868
Phone
(913) 286-7640
NPI assigned
Jul 19, 2023
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3543 KS Primary

Addresses

Primary practice location

8575 W 110TH St # 208
Overland Park, KS 66210-1868

Mailing address

1211 Olive St
Leavenworth, KS 66048-2361
Phone (231) 838-0582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3543KSMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1104506716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 OLIVE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660482361",
            "telephone_number": "231-838-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 W 110TH ST # 208",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101868",
            "telephone_number": "913-286-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLIN",
        "first_name": "MICHAEL",
        "middle_name": "ALLAN-JOSEPH",
        "credential": "LPC, LMAC, CTP, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KS",
            "license": "3543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.