Stanley D Kolpak II, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH1211688 Issued in WA

Practice address

604 N 13TH St
Elma, WA 98541-9330

Phone

(360) 470-4277

Fax

(360) 532-8786

NPI assigned

Jun 7, 2017

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kolpak Counseling

  • Adult Mental Health Clinic/Center
  • Elma, WA
  • NPI 1578395737
  NPD Authorized official

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1538698147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N 13TH ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419330",
            "telephone_number": "360-470-4277",
            "fax_number": "360-532-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N 13TH ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419330",
            "telephone_number": "360-470-4277",
            "fax_number": "360-532-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLPAK",
        "first_name": "STANLEY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH1211688",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61513857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Renae Jurasin, ARNP
• Deepinderjeet Kaur, DDS
• Christian R Koehler, CFCS
• Joseph Hans Kohn, ARNP-C
• Kolpak Counseling
• Cassidy Kramp
• Laboratory Corporation of America
• Katala Lach, ARNP
• Belinda Viann Lear, M.D.
• Lee & Hwang PLLC

• Mental Health Counselor in Elma, WA
• Providers in Elma, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.