Amanda Marie Kolich, LPC-IT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

7124226 Issued in WI

Practice address

101 W Evergreen Pkwy Ste 1
Elkhorn, WI 53121-4083

Phone

(262) 475-5684

NPI assigned

Sep 27, 2022

Sex

Female

Sole proprietor

Yes

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

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• American Behavioral Clinics, SC

  • Psychiatry Physician
  • Milwaukee, WI
  • NPI 1144313859
  Medicare reassignment NPD

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1295459949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W COURT ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211652",
            "telephone_number": "414-651-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W EVERGREEN PKWY STE 1",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214083",
            "telephone_number": "262-475-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLICH",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "LPC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "7124226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Knutson, PHARM.D.
• Austin C Ko, DO
• Alison Ann Kohler, MD
• Christa Kokott, OT
• Wesley Kokott, PT
• Lisa Kommer, PT
• Jodi Koppein
• Alicia Kovac, LCSW
• Jeffrey Alan Kowalski, MD
• Elizabeth J Kresen, RDH

• Counselor in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.