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NPI Code Detail

MEDICARE: MR. COLBERTSON KREGER LPCC

MEDICARE: MR. COLBERTSON KREGER LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.2505736OH

General Provider Information

NPI Number : 1306303540
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. COLBERTSON KREGER LPCC
Provider Business Mailing Address
First Line : 7547 MENTOR AVE STE 306
Second Line :
City : MENTOR
State : OH
Zip : 44060-5432
Country : US
Telephone Number : 440-701-6170
Fax Number : 440-527-8043
Provider Business Practice Location Address
First Line : 7547 MENTOR AVE STE 300
Second Line :
City : MENTOR
State : OH
Zip : 44060-5432
Country : US
Telephone Number : 440-701-6170
Fax Number : 440-527-8043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2019
Last Update Date : 11/15/2025

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Directions to “ MR. COLBERTSON KREGER LPCC” Practice Location

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