Active NPI
Carly Koller, LPCC
- Professional Counselor
- Chagrin Falls, OH
National Provider Identifier
1841747292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.2404971
- Practice address
- 18020 Stoney Brook CT
Chagrin Falls, OH 44023-4845 - Phone
- (440) 821-8552
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- 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 | E.2404971 | OH | Primary |
Addresses
Primary practice location
18020 Stoney Brook CT
Chagrin Falls, OH 44023-4845
Mailing address
18020 Stoney Brook CT
Chagrin Falls, OH 44023-4845
Phone (440) 821-8552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.2404971 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736726400000",
"number": "1841747292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18020 STONEY BROOK CT",
"city": "CHAGRIN FALLS",
"state": "OH",
"postal_code": "440234845",
"telephone_number": "440-821-8552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18020 STONEY BROOK CT",
"city": "CHAGRIN FALLS",
"state": "OH",
"postal_code": "440234845",
"telephone_number": "440-821-8552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLLER",
"first_name": "CARLY",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2025-01-13",
"certification_date": "2025-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.2404971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chagrin Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.