Matthew Jason Kotecki, BSHS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1022 E Main St
Benton Harbor, MI 49022

Phone

(269) 962-0051

Fax

(269) 962-0123

NPI assigned

Apr 8, 2021

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1629658380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13206 TAFT RD",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159406",
            "telephone_number": "616-422-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 E MAIN ST",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "49022",
            "telephone_number": "269-962-0051",
            "fax_number": "269-962-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTECKI",
        "first_name": "MATTHEW",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "BSHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Kobylinski
• Kristina Kofnovec
• Victoria Rose Kolenko
• Clara Kolinek
• Diane Kopp, LPC
• Allison Kottackal, FNP
• Ashley Koubaitary
• Robert B Kress, RPH CCN
• Daniel Krosschell, PHARMD
• Fern Krosschell

• Mental Health Counselor in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.