Provider Demographics
NPI:1518709658
Name:KOLICH, WHITNEY (PEER RECOVERY COACH)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:KOLICH
Suffix:
Gender:F
Credentials:PEER RECOVERY COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 ROCK ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4783
Mailing Address - Country:US
Mailing Address - Phone:906-227-9176
Mailing Address - Fax:906-228-2469
Practice Address - Street 1:1100 LUDINGTON ST
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-3542
Practice Address - Country:US
Practice Address - Phone:906-786-7212
Practice Address - Fax:906-786-0676
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist