MEDICARE: JAYME KOLBO 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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1760848493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYME KOLBO LPCC

Provider Business Mailing Address
First Line	:	656 ARMSTRONG AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-3802
Country	:	US
Telephone Number	:	651-434-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	656 ARMSTRONG AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-3802
Country	:	US
Telephone Number	:	651-434-5151
Fax Number	:	651-447-5137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	06/16/2023

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