Colleen Kolb, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1023-124 Issued in WI

Practice address

1716 Fordem Ave
Madison, WI 53704-4604

Phone

(608) 221-3511

Fax

(608) 221-3514

NPI assigned

May 21, 2013

Last updated

Mar 24, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Colleen Boland Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Marriage and Family Therapist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moontree Psychotherapy Center LLCGroup PAC ID 3274660295, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Moontree Psychotherapy Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1770806259
  Medicare reassignment Care Compare group NPD
• Children's Service Society of Wisconsin

  • Clinical Social Worker
  • Madison, WI
  • NPI 1528232386

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1710323365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SUNSET DR",
            "city": "DE FOREST",
            "state": "WI",
            "postal_code": "535321123",
            "telephone_number": "608-495-0869",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 FORDEM AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044604",
            "telephone_number": "608-221-3511",
            "fax_number": "608-221-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "COLLEEN",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1023-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710323365",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "BOLAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney E. Kohn, M.D.
• Patricia K Kokotailo, MD
• Jeffrey T Kokott, M.D.
• Bryan D Kokx, MD
• Anne M Kolan, MD
• Gregory G Kolden, PHD
• Christine J Kolehmainen, M.D.
• Jill Kolesar, RPH
• Amie Marie Kolimas, DO
• Jeanne Kolker, MA, PC

• Marriage & Family Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.