Kourtney Cola

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.185652 Issued in OH

Practice address

3418 Lake Ave
Ashtabula, OH 44004-5763

Phone

(440) 650-5030

NPI assigned

Sep 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Square One Health LLC

  • Community/Behavioral Health Agency
  • Ashtabula, OH
  • NPI 1326717190
  NPD

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1477339620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440045763",
            "telephone_number": "440-650-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440045763",
            "telephone_number": "440-650-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLA",
        "first_name": "KOURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.185652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinical Practice of Lecom Institute for Successful Living
• Cloudbreak Counseling Services, LLC
• Brittany Marie Coach, CNP
• Rebecca Michelle Coffin, APRN FNP
• Kathryn Ann Coffman, DPT
• Mia Coladangelo
• Jena Colby
• Cole Vision Corporation
• Breanna Cole
• Keahmbi Coleman

• Addiction (Substance Use Disorder) Counselor in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.