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Active NPI 1063584225 Individual Practitioner Female Practitioner

Debra A Koltis , MS, LPC, SAC, NCC

Counselor - Professional • Thorp, WI

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Debra Koltis, MS, LPC, SAC, NCC is a registered healthcare professional specializing in Counselor - Professional in Thorp, WI. Official NPI practice address is registered at W10274 EDDY RD.

Practice Location & Contact Primary Location

Practice Address

W10274 Eddy Rd

Thorp, WI 547717626

Telephone 7154976478
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Thorp, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.8 Yrs
Regional Practice Density
1 Specialists

Practicing in Thorp, WI (4511 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-04-17
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License WI 3438-125

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License WI 15167

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License WI 3438-125

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
409-78700 (WI)
Commercial Insurance / Payer ID Security Health Plan
93156 (WI)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location April 17, 2020

Registered at W10274 EDDY RD, THORP, WI 547717626 (Tel: 7154976478)

📍
Updated Business Mailing Address April 17, 2020

Registered at W10274 EDDY RD, THORP, WI 547717626 (Tel: 7154976478)

NPI Profile Active November 07, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location November 07, 2011

Registered at 136 W BROADWAY AVE, MEDFORD, WI 544511757 (Tel: 7157484535)

📍
Updated Business Mailing Address November 07, 2011

Registered at 136 W BROADWAY AVE, PO BOX 297, MEDFORD, WI 544511757 (Tel: 7157484535)

👤
Provider Name / Credentials Updated November 07, 2011

Recorded as DEBRA KOLTIS, MS,LPC,SAC,NCC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 07, 2011

Counselor (License #15167 in WI)

🟢
Initial NPI Registration & Enumeration November 14, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063584225
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 14, 2006
Last Update: April 17, 2020
Sole Proprietor: Yes

Mailing Address

W10274 Eddy Rd

Thorp, WI 547717626

Phone: 7154976478

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.