Healthcare Provider Details

I. General information

NPI: 1437079803
Provider Name (Legal Business Name): NICHOLAS KOLATSKI LPC-IT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 W NATIONAL AVE
WEST ALLIS WI
53227-1734
US

IV. Provider business mailing address

1640 S 82ND ST
WEST ALLIS WI
53214-4423
US

V. Phone/Fax

Practice location:
  • Phone: 414-405-1682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9194-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: