Individual provider Active NPI

Renee T Kolecki, PCC-S

  • Professional Counselor
  • Lakewood, OH
National Provider Identifier
1407074362
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0004147 Issued in OH
Practice address
14701 Detroit Ave
Lakewood, OH 44107-4115
Phone
(216) 228-0010
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.0004147 OH Primary

Addresses

Primary practice location

14701 Detroit Ave
Lakewood, OH 44107-4115

Mailing address

412 Muirfield Dr
Highland Heights, OH 44143-3636
Phone (216) 870-6672

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

State licenses

LicenseStateTypeSpecialty
E.0004147OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1407074362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 MUIRFIELD DR",
            "city": "HIGHLAND HEIGHTS",
            "state": "OH",
            "postal_code": "441433636",
            "telephone_number": "216-870-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074115",
            "telephone_number": "216-228-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLECKI",
        "first_name": "RENEE",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "PCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0004147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.