Basic Information
| Provider Information | |||||||||
| NPI: | 1235272147 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOLBE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LPC, LLP, FLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2590 BENSTON RD | ||||||||
| Address2: | |||||||||
| City: | WHITEHALL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494619523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2318938336 | ||||||||
| FaxNumber: | 2318938336 | ||||||||
| Practice Location | |||||||||
| Address1: | 516 E COLBY ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | WHITEHALL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494611104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2318938336 | ||||||||
| FaxNumber: | 2319815277 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 11/18/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | L905346 | MI | N | Behavioral Health & Social Service Providers | Counselor | Professional | 103T00000X | L705120 | MI | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.