Individual provider Active NPI

Luca Jayce Kohl, CADC-R, QMHA-R

  • Addiction (Substance Use Disorder) Counselor
  • Albany, OR
National Provider Identifier
1740782911
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1405403 Issued in OR
Practice address
1010 11TH Ave SW
Albany, OR 97321-2019
Phone
(541) 619-9927
NPI assigned
Mar 5, 2018
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1405403 OR Primary

Addresses

Primary practice location

1010 11TH Ave SW
Albany, OR 97321-2019

Mailing address

1010 11TH Ave SW
Albany, OR 97321-2019
Phone (541) 619-9927

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

State licenses

LicenseStateTypeSpecialty
1405403ORMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1740782911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 11TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212019",
            "telephone_number": "541-619-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 11TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212019",
            "telephone_number": "541-619-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHL",
        "first_name": "LUCA",
        "middle_name": "JAYCE",
        "credential": "CADC-R, QMHA-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-05",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "1405403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.