Sawyer Jade Kolaczkowski, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

325 Il Route 2
Dixon, IL 61021-9118

Phone

(815) 284-6611

NPI assigned

Sep 8, 2021

Last updated

Jun 3, 2024By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sinnissippi Centers, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochelle, IL
  • NPI 1407143837
  NPD
• Sinnissippi Centers, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oregon, IL
  • NPI 1437446861
  NPD
• Sinnissippi Centers, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Dixon, IL
  • NPI 1538447313
  NPD

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1114696762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 IL ROUTE 2",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 IL ROUTE 2",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219118",
            "telephone_number": "815-284-6611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "IL",
            "postal_code": "610813699",
            "country_code": "US",
            "telephone_number": "779-297-7016",
            "fax_number": "779-297-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLACZKOWSKI",
        "first_name": "SAWYER",
        "middle_name": "JADE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.020239",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly L Klein, O.D.
• Kelly L Kliebe
• Morgan E Knight
• Megan Koch, MHP
• Christina Ashley Koenig, MT-BC
• Nicole Lynn Kolve
• Tammy Jean Kolve
• Vanessa Inez Kolve, RN
• Marissa Elaine Krager
• Kreider Services Inc

• Mental Health Counselor in Dixon, IL
• Providers in Dixon, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.