Individual provider Active NPI

Kathleen Jo Kolosik, MS, LMFT

  • Marriage & Family Therapist
  • Medford, OR
National Provider Identifier
1669951588
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T3204 Issued in OR
Practice address
200 Beatty St
Medford, OR 97501-5811
Phone
(541) 476-2373
NPI assigned
Aug 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T3204 OR Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

200 Beatty St
Medford, OR 97501-5811

Mailing address

1215 SW G St
Grants Pass, OR 97526-2544
Phone (541) 476-2373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20251015002818 OR Practitioner - Marriage and Family Therapist 7517454341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Options for Southern OregonGroup PAC ID 0941202006, 70 clinicians

Practice addresses (Care Compare)

200 Beatty St
Medford, OR 97501-5811
Phone (541) 476-2373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
T3204ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Options for Southern Oregon CurrentSince Aug 5, 2025 Accepting new patients
Options for Southern Oregon Current Accepting new patients

Locations

1215 SW G St
Grants Pass, OR 97526
Phone (541) 244-4109

200 Beatty St
Medford, OR 97501
Phone (541) 414-0739

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1669951588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BEATTY ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015811",
            "telephone_number": "541-476-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLOSIK",
        "first_name": "KATHLEEN",
        "middle_name": "JO",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T3204",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.