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NPI Code Detail

MEDICARE: AMY LOUISE COLOMBO

MEDICARE: AMY LOUISE COLOMBO
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
1101YM0800XMental Health Counselor6401005585MI

General Provider Information

NPI Number : 1588529101
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LOUISE COLOMBO
Provider Business Mailing Address
First Line : 4230 COPPER RIDGE DR BLDG E
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7256
Country : US
Telephone Number : 231-935-6880
Fax Number :
Provider Business Practice Location Address
First Line : 4230 COPPER RIDGE DR BLDG E
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7256
Country : US
Telephone Number : 231-935-6880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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Directions to “ AMY LOUISE COLOMBO ” Practice Location

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