Provider Demographics
NPI:1093132615
Name:KOLB, KAREN (LMSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KOLB
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4119
Mailing Address - Country:US
Mailing Address - Phone:845-522-4780
Mailing Address - Fax:
Practice Address - Street 1:41 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4119
Practice Address - Country:US
Practice Address - Phone:845-522-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090627104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker