Healthcare Provider Details

I. General information

NPI: 1073477543
Provider Name (Legal Business Name): VALERIE JO KOLICK MA, LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18213 HILLCREST AVE
OLNEY MD
20832-1422
US

IV. Provider business mailing address

6827 REHNQUIST CT
NEW MARKET MD
21774-6847
US

V. Phone/Fax

Practice location:
  • Phone: 301-417-5979
  • Fax:
Mailing address:
  • Phone: 301-524-9473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17327
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: