Active NPI
Luke Koll
- Mental Health Counselor
- San Luis Obispo, CA
National Provider Identifier
1891046595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 36547
- Practice address
- 2178 Johnson Ave
San Luis Obispo, CA 93401-4535 - Phone
- (805) 781-4711
- NPI assigned
- Sep 21, 2012
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 36547 | CA | Primary |
Addresses
Primary practice location
2178 Johnson Ave
San Luis Obispo, CA 93401-4535
Mailing address
454 Helen St
Paso Robles, CA 93446-3202
Phone (805) 712-9154
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348185600000",
"number": "1891046595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "454 HELEN ST",
"city": "PASO ROBLES",
"state": "CA",
"postal_code": "934463202",
"telephone_number": "805-712-9154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2178 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014535",
"telephone_number": "805-781-4711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLL",
"first_name": "LUKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-21",
"last_updated": "2012-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "36547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.