Active NPI
Emil Jay Kolick VIII, M.S.
- Addiction (Substance Use Disorder) Counselor
- Phoenixville, PA
National Provider Identifier
1134518905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 4498
- Practice address
- 536 Onward Ave
Phoenixville, PA 19460-5928 - Phone
- (484) 302-4425
- NPI assigned
- Jan 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | I0147 | PA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4498 | PA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4759 | PA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | FAC-K1308300929 |
Addresses
Primary practice location
536 Onward Ave
Phoenixville, PA 19460-5928
Mailing address
536 Onward Ave
Phoenixville, PA 19460-5928
Phone (484) 302-4425
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4498 | Other | PA | PCB CERTIFIED ALCOHOL AND DRUG COUNSELOR |
| 4759 | Other | PA | PCB ASSOCIATE PREVENTION SPECIALIST II |
| FAC-K1308300929 | Other | FORENSIC ADDICTIONS COUNSELOR: BREINING INSTITUTE | |
| FAC-K1308300929 | Other | BREINING INSTITUTE: MASTERS LEVEL- REGISTERED ADDICTION SPECIALIST (M-RAS) | |
| 4759 | Other | PA | PCB CERTIFIED CRIMINAL JUSTICE ADDICTIONS PROFESSIONAL |
| FAC-K1308300929 | Other | BREINING INSTITUTE: CERTIFIED CO-OCCURRING DISORDER SPECIALIST | |
| 802836 | Other | IC&RC CERTIFIED ALCOHOL AND DRUG COUNSELOR | |
| I0147 | Other | PA | PCB CERTIFIED INTERVENTION PROFESSIONAL |
| 502300 | Other | IC&RC CERTIFIED CRIMINAL JUSTICE ADDICTIONS PROFESSIONAL |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I0147 | PA | MD | Counselor |
| 4498 | PA | MD | Addiction (Substance Use Disorder) Counselor |
| 4759 | PA | MD | Clinical Laboratory Director (Non-physician) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421366400000",
"number": "1134518905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "536 ONWARD AVE",
"city": "PHOENIXVILLE",
"state": "PA",
"postal_code": "194605928",
"telephone_number": "484-302-4425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "536 ONWARD AVE",
"city": "PHOENIXVILLE",
"state": "PA",
"postal_code": "194605928",
"telephone_number": "484-302-4425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLICK",
"first_name": "EMIL",
"middle_name": "JAY",
"name_prefix": "Mr.",
"name_suffix": "VIII",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-16",
"last_updated": "2015-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "I0147",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "PA",
"license": "4498",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "PA",
"license": "4759",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": "FAC-K1308300929",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PCB CERTIFIED ALCOHOL AND DRUG COUNSELOR",
"identifier": "4498",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PCB ASSOCIATE PREVENTION SPECIALIST II",
"identifier": "4759",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FORENSIC ADDICTIONS COUNSELOR: BREINING INSTITUTE",
"identifier": "FAC-K1308300929",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BREINING INSTITUTE: MASTERS LEVEL- REGISTERED ADDICTION SPECIALIST (M-RAS)",
"identifier": "FAC-K1308300929",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PCB CERTIFIED CRIMINAL JUSTICE ADDICTIONS PROFESSIONAL",
"identifier": "4759",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BREINING INSTITUTE: CERTIFIED CO-OCCURRING DISORDER SPECIALIST",
"identifier": "FAC-K1308300929",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IC&RC CERTIFIED ALCOHOL AND DRUG COUNSELOR",
"identifier": "802836",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PCB CERTIFIED INTERVENTION PROFESSIONAL",
"identifier": "I0147",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IC&RC CERTIFIED CRIMINAL JUSTICE ADDICTIONS PROFESSIONAL",
"identifier": "502300",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenixville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.