Individual provider Active NPI

Donald Leon Kollak, CAC II

  • Addiction (Substance Use Disorder) Counselor
  • Commerce City, CO
National Provider Identifier
1982948758
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
3838 Issued in CO
Practice address
7373 Birch St
Commerce City, CO 80022-1446
Phone
(303) 412-3962
NPI assigned
Nov 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3838 CO Primary

Addresses

Primary practice location

7373 Birch St
Commerce City, CO 80022-1446

Mailing address

7373 Birch St
Commerce City, CO 80022-1446

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

State licenses

LicenseStateTypeSpecialty
3838COMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1982948758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 BIRCH ST",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800221446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 BIRCH ST",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800221446",
            "telephone_number": "303-412-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLAK",
        "first_name": "DONALD",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "credential": "CAC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "3838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce City, CO

Sources for this page

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

Verify at the official NPI Registry.