Active NPI
Beth Leigh Kolakoski, LMFT
- Marriage & Family Therapist
- San Rafael, CA
National Provider Identifier
1467503227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 100338
- Practice address
- 1050 Northgate Dr
San Rafael, CA 94903-2526 - Phone
- (415) 425-2523
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 100338 | CA | Primary |
Addresses
Primary practice location
1050 Northgate Dr
San Rafael, CA 94903-2526
Mailing address
1355 Sir Francis Drake Blvd
Apt #9
San Anselmo, CA 94960-1804
Phone (415) 724-7401
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100338 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1467503227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1355 SIR FRANCIS DRAKE BLVD",
"address_2": "APT #9",
"city": "SAN ANSELMO",
"state": "CA",
"postal_code": "949601804",
"telephone_number": "415-724-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 NORTHGATE DR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949032526",
"telephone_number": "415-425-2523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLAKOSKI",
"first_name": "BETH",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "100338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.