Nicholas Robert Koontz, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF68820 Issued in CA

Practice address

2200 E Route 66
Glendora, CA 91740-4659

Phone

(626) 859-2089

Fax

(626) 859-6537

NPI assigned

Jul 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

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.

• Meridian Counseling

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1396202206
  Medicare reassignment NPD

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1821301292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E ROUTE 66",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404659",
            "telephone_number": "626-859-2089",
            "fax_number": "626-859-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E ROUTE 66",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404659",
            "telephone_number": "626-859-2089",
            "fax_number": "626-859-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "NICHOLAS",
        "middle_name": "ROBERT",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF68820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark B Kislinger, M.D.
• Matthew C Klingler, D.P.T.
• Keaunna Sonae Knox, SLP
• Koi Concepts
• John A Kolta, RPH
• Ashlene Janiece Korcek, PA-C
• Erika Christenson Kosterlitzky, LMFT
• Selena Isela Kradolfer, LMFT
• Krekor a Tomassian MD a Prof Corp
• Krunal J Mehta MD Inc

• Mental Health Counselor in Glendora, CA
• Providers in Glendora, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.