DEBRA A KOLTIS MSLPCSACNCC NPI 1063584225

NPI Information

NPI: 1063584225
Provider Name: DEBRA A KOLTIS, MS,LPC,SAC,NCC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
W10274 EDDY RD
THORP, WI
ZIP 54771
Phone: (715) 497-6478
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Debra A Koltis, MS,LPC,SAC,NCC is a professional counselor in Thorp, WI. Debra A Koltis, MS,LPC,SAC,NCC NPI is 1063584225. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

W10274 EDDY RD
THORP, WI
ZIP 54771-626
Phone: (715) 497-6478

The enumeration date for this NPI number is 11/14/2006 and was last updated on 4/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	15167	WISCONSIN	No
2	101YM0800X	Counselor	Mental Health	3438-125	WISCONSIN	No
3	101YP2500X	Counselor	Professional	3438-125	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	409-78700	MEDICAID	WISCONSIN
2	93156	OTHER	WISCONSIN	SECURITY HEALTH PLAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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