Michael D Kolasa, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

122176 Issued in AK

Practice address

600 University Ave
Ste 5
Fairbanks, AK 99709

Phone

(907) 347-1989

Fax

(907) 459-8201

NPI assigned

Aug 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1467979724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72461",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997072461",
            "telephone_number": "907-347-1989",
            "fax_number": "907-459-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY AVE",
            "address_2": "STE 5",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "99709",
            "telephone_number": "907-347-1989",
            "fax_number": "907-459-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLASA",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-28",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "122176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL COUNSELOR",
            "identifier": "122176",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Ann Kohntopp, RN
• Karen L. Kohout, L. C. S. W.
• Marie Kokrine, BSW
• Ronald Marvin Kokrine
• Laura Kolasa
• Hanna Konarzewska, M.D.
• Theresa Konieczny, MSN, APRN, FNP-C
• Sarah Koogle, B.A
• Shyanne Mandy Kopanuk
• Heather Koponen, PA-C

• Professional Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Professional Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.