Provider Demographics
NPI:1275249906
Name:COLDING, KATHERINE JOELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JOELLE
Last Name:COLDING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 MARBRISA DR APT 802
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-6331
Mailing Address - Country:US
Mailing Address - Phone:863-990-5541
Mailing Address - Fax:
Practice Address - Street 1:2801 W BUSCH BLVD STE 103
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4500
Practice Address - Country:US
Practice Address - Phone:727-490-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW208951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical