Healthcare Provider Details

I. General information

NPI: 1033822713
Provider Name (Legal Business Name): CHANCE KOLHMEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 ROUTE 228 # 1040
CRANBERRY TOWNSHIP PA
16066-5307
US

IV. Provider business mailing address

1675 ROUTE 228 # 1040
CRANBERRY TOWNSHIP PA
16066-5307
US

V. Phone/Fax

Practice location:
  • Phone: 412-444-5134
  • Fax:
Mailing address:
  • Phone: 412-444-5134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC017713
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC017713
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: