Katherine Koncilja, M.A., LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E1000011 Issued in OH

Practice address

215 Miller Rd Ste 7
Avon Lake, OH 44012-1013

Phone

(440) 742-1661

Fax

(440) 653-9576

NPI assigned

Jun 14, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• New Leaf Counseling Services LLC

  • Professional Counselor
  • Avon Lake, OH
  • NPI 1609197631

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1831410869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MILLER RD STE 7",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121013",
            "telephone_number": "440-742-1661",
            "fax_number": "440-653-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MILLER RD STE 7",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121013",
            "telephone_number": "440-742-1661",
            "fax_number": "440-653-9576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Miller Rd",
            "address_purpose": "LOCATION",
            "city": "Avon Lake",
            "state": "OH",
            "postal_code": "440121004",
            "country_code": "US",
            "telephone_number": "440-742-1661",
            "fax_number": "440-930-2085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONCILJA",
        "first_name": "KATHERINE",
        "credential": "M.A., LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E1000011",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "090037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan L. Kent, MA CCC-SLP
• Julia Khrenovsky
• Audrey Kirby
• Jeremy Scott Klepper, PHARM.D, R.PH
• Anelise Kollias
• Michael James Kotowski, D.D.S.
• Nancy Elizabeth Kovacs
• Nikki Krischer, PTA
• Jeffrey Peter Kucharson, D.D.S.
• Glenn Joseph Kuemerle, DDS

• Professional Counselor in Avon Lake, OH
• Providers in Avon Lake, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.