Kalee Koronka, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401223667 Issued in MI

Practice address

1199 Harris Ave
Tawas City, MI 48763-9681

Phone

(989) 362-8636

Fax

(989) 362-7800

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kalee Nicholson Former name

Medicare fee-for-service enrollment

Enrolled in MI

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 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.

• Ausable Valley Community Mental Health Services Board

  • Community/Behavioral Health Agency
  • Tawas City, MI
  • NPI 1417011701
  Medicare reassignment NPD
• Ausable Valley CMH

  • Clinic/Center
  • Tawas City, MI
  • NPI 1952628893
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1982207924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 310",
            "address_2": "1199 W. HARRIS AVE.",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "48764",
            "telephone_number": "989-362-8636",
            "fax_number": "989-362-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 HARRIS AVE",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639681",
            "telephone_number": "989-362-8636",
            "fax_number": "989-362-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORONKA",
        "first_name": "KALEE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALEE",
            "last_name": "NICHOLSON",
            "credential": "MA, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gordon Kalo, CRNA
• Laura Lynn Kauffman, LMSW
• Michael Jay Kayner, DC
• Taylor Laine Kinney
• Bradley Arthur Kloska, D.O.
• Charles Edward Kudwa, DDS
• Nancy Elaine Laidlaw, AUD
• Lakeview Manor Acquisition Company, Inc.
• Christopher Russell Landrey, DO
• David Ballard Lane Jr., LMSW, LLP, LPC

• Professional Counselor in Tawas City, MI
• Providers in Tawas City, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2024; 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.