Active NPI
Paul Arthur Kolak, M.A., L.P.C.
- Professional Counselor
- Traverse City, MI
National Provider Identifier
1720138480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401007685
- Practice address
- 1055 Carriage Hill Dr
Traverse City, MI 49686-5161 - Phone
- (231) 995-0870
- NPI assigned
- Jan 12, 2007
- Last updated
- Mar 12, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401007685 | MI | Primary |
Addresses
Primary practice location
1055 Carriage Hill Dr
Traverse City, MI 49686-5161
Mailing address
20353 Hunter Ridge
Lake Ann, MI 49650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401007685 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236816000000",
"number": "1720138480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20353 HUNTER RIDGE",
"city": "LAKE ANN",
"state": "MI",
"postal_code": "49650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 CARRIAGE HILL DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496865161",
"telephone_number": "231-995-0870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLAK",
"first_name": "PAUL",
"middle_name": "ARTHUR",
"name_prefix": "Mr.",
"credential": "M.A., L.P.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2009-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401007685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.