Provider Demographics
NPI:1326276064
Name:SOLBERG, KRISTIN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:SOLBERG
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 1:1350 N ORANGE AVE
Mailing Address - Street 2:SUITE223
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4945
Mailing Address - Country:US
Mailing Address - Phone:407-644-4367
Mailing Address - Fax:407-622-1200
Practice Address - Street 1:1350 N ORANGE AVE
Practice Address - Street 2:SUITE223
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4945
Practice Address - Country:US
Practice Address - Phone:407-644-4367
Practice Address - Fax:407-622-1200
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW92981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical