Theresa Ann Kollars, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1675 Winter St NE
Salem, OR 97301-7152

Phone

(503) 585-0351

Fax

(503) 585-0212

NPI assigned

Feb 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Mental Health Counselor

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem Psychiatric Associates PCGroup PAC ID 6002702420, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Salem Psychiatric Associates, P.C.

  • Psychiatry Physician
  • Salem, OR
  • NPI 1619061314
  Care Compare group
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD (past)

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1376175398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16860 OAKDALE RD",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973389650",
            "telephone_number": "503-881-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 WINTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017152",
            "telephone_number": "503-585-0351",
            "fax_number": "503-585-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLARS",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "2684247",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5462",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Marie Koch, OTR/L
• Linda Kay Koehn, PHARMD
• Erik Kokkonen, M.D.
• Callie Kolb, MS CCC-SLP
• Vincent J Koletar, MD
• Derek Koller, M.D.
• Alexandria Mary Kolody, LPN
• Laslo Emory Kolta, M.D.
• Lawrence Konick, MD
• Lisa Ann Callery Koontz, RN, LMT

• Professional Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.