Gary L Kolb, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH 60165337 Issued in WA

Practice address

1918 Simpson Ave
Aberdeen, WA 98520-3603

Phone

(360) 533-8887

Fax

(360) 533-8887

NPI assigned

Sep 10, 2010

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1275840225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 SIMPSON AVE",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985203603",
            "telephone_number": "360-533-8887",
            "fax_number": "360-533-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 SIMPSON AVE",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985203603",
            "telephone_number": "360-533-8887",
            "fax_number": "360-533-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "GARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP 00005118",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH 60165337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Aberdeen, WA
• Providers in Aberdeen, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.