Individual provider Active NPI

James Charles Kowalski, LPC, MAC

  • Mental Health Counselor
  • Dunedin, FL
National Provider Identifier
1386721355
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC003377 Issued in GA
Practice address
620 Edgewater Dr Unit 604
Dunedin, FL 34698-6965
Phone
(706) 835-6515
Fax
(706) 835-6515
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 2066 WV
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X LPC4433 NC
Mental Health Counselor 101YM0800X LPC003377 GA Primary

Addresses

Primary practice location

620 Edgewater Dr Unit 604
Dunedin, FL 34698-6965

Mailing address

620 Edgewater Dr Unit 604
Dunedin, FL 34698-6965
Phone (706) 835-6515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240118001752 GA Practitioner - Mental Health Counselor 8921450636 Reassigns benefits to 1 organization
I20240206004718 NC Practitioner - Mental Health Counselor 8921450636 Reassigns benefits to 1 organization
I20240419000351 FL Practitioner - Mental Health Counselor 8921450636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriving LaneGroup PAC ID 1355741083, 24 clinicians

Practice addresses (Care Compare)

2801 Buford Hwy NE
Suite T10
Atlanta, GA 30329-2149
Phone (347) 830-7720

4801 Glenwood Ave
Suite 200
Raleigh, NC 27612-3857
Phone (347) 830-7720

4933 Tamiami TRL N
Suite 200
Naples, FL 34103-3028
Phone (347) 830-7720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC4433NCMDMental Health Counselor
2066WVMDMental Health Counselor
4433NCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thriving Lane Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Elizabeth a Strickler PHD PC Single Specialty Past Accepting new patients

Locations

4933 Tamiami Trl N
Ste 200
Naples, FL 34103
Phone (239) 272-9157

200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515

2801 Buford Hwy NE
Ste T10
Brookhaven, GA 30329
Phone (404) 397-8302

4801 Glenwood Ave
Ste 200
Raleigh, NC 27612
Phone (757) 866-2715

Interoperability endpoints

  • Direct secure messaging: thrivinglanellc.jamesckowalski@149897.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1386721355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 EDGEWATER DR UNIT 604",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346986965",
            "telephone_number": "706-835-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 EDGEWATER DR UNIT 604",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346986965",
            "telephone_number": "706-835-6515",
            "fax_number": "706-835-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "JAMES",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "LPC, MAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2066",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "LPC4433",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC003377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.